Provider Demographics
NPI:1790238590
Name:KANG, KYU HYUNG (DDS)
Entity Type:Individual
Prefix:
First Name:KYU HYUNG
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 JUNCTION BLVD APT 25D
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2874
Mailing Address - Country:US
Mailing Address - Phone:646-532-7518
Mailing Address - Fax:
Practice Address - Street 1:6155 JUNCTION BLVD APT 25D
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2874
Practice Address - Country:US
Practice Address - Phone:646-532-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program