Provider Demographics
NPI:1245649680
Name:KANG, JAMES Y (DMD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:Y
Last Name:KANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4313
Mailing Address - Country:US
Mailing Address - Phone:201-345-8881
Mailing Address - Fax:201-345-8917
Practice Address - Street 1:485 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4313
Practice Address - Country:US
Practice Address - Phone:201-588-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.248771223G0001X
NY0576511223G0001X
NJ22DI025788001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice