Provider Demographics
NPI:1821498981
Name:HWANG DENTAL CORPORATION
Entity Type:Organization
Organization Name:HWANG DENTAL CORPORATION
Other - Org Name:ANGEL DENTAL GROUP WILSHIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:KI SIK
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-384-3389
Mailing Address - Street 1:3540 WILSHIRE BLVD
Mailing Address - Street 2:STE. 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2307
Mailing Address - Country:US
Mailing Address - Phone:213-384-3389
Mailing Address - Fax:213-381-7770
Practice Address - Street 1:3540 WILSHIRE BLVD
Practice Address - Street 2:STE. 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2307
Practice Address - Country:US
Practice Address - Phone:213-384-3389
Practice Address - Fax:213-381-7770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGEL DENTAL GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1801094610OtherNPI