Eul-Mo Kang, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401006989 Issued in VA

Practice address

4540A John Marr Dr
Annandale, VA 22003

Phone

(703) 333-3016

Fax

(703) 333-3018

NPI assigned

Jan 14, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• John E Kang Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• KY PPO C-SNP
• TN PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John E Kang DDS

  • Dental Clinic/Center
  • Annandale, VA
  • NPI 1013785724
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1003053984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540A JOHN MARR DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-333-3016",
            "fax_number": "703-333-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540A JOHN MARR DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-333-3016",
            "fax_number": "703-333-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "EUL-MO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "KANG",
            "middle_name": "E",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Felicia B Kallon
• Laurance W Kam, MD
• Aleo Kamara
• Mollie Kamerow
• Virginia Kane, MS, OTR/L
• Jin Hee Kang
• Jonathan Dongho Kang, D.C.
• Atoosa Kashani, DPM
• Jillian Kim Kasowski, PTA
• Kathy E. Wolf, M.D., P.C.

• General Practice Dentistry in Annandale, VA
• Providers in Annandale, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.