Provider Demographics
NPI:1770560583
Name:KANG, YOUNG SEON (DDS)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:SEON
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 1:16300 AURORA AVE N
Mailing Address - Street 2:SUITE G
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-2602
Mailing Address - Country:US
Mailing Address - Phone:206-546-2322
Mailing Address - Fax:206-542-3818
Practice Address - Street 1:16300 AURORA AVE N
Practice Address - Street 2:SUITE G
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-2602
Practice Address - Country:US
Practice Address - Phone:206-546-2322
Practice Address - Fax:206-542-3818
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000084451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice