Provider Demographics
NPI:1013128677
Name:KANG, YOUNG HWA (DDS)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:HWA
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 1:3544 W OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3500
Mailing Address - Country:US
Mailing Address - Phone:323-735-0448
Mailing Address - Fax:323-735-4827
Practice Address - Street 1:3544 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3500
Practice Address - Country:US
Practice Address - Phone:323-735-0448
Practice Address - Fax:323-735-4827
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADA319341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice