Eugene C Kang, MD, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DR.0055871 Issued in CO

Practice address

671 Mitchell Way
Suite 100
Erie, CO 80516-5445

Phone

(303) 954-0049

Fax

(720) 638-7577

NPI assigned

Aug 4, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1093946378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 MITCHELL WAY",
            "address_2": "SUITE 100",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805165445",
            "telephone_number": "303-954-0049",
            "fax_number": "720-638-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 MITCHELL WAY",
            "address_2": "SUITE 100",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805165445",
            "telephone_number": "303-954-0049",
            "fax_number": "720-638-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "EUGENE",
        "middle_name": "C",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CO",
            "license": "DR.0055871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Dawn Johns
• Ashley Nicole Jordan, OTR/L
• Sharon Adele Justice, PT, DPT
• Justin K. Cole (Great Day Chiropractic & Wellness Center)
• Tenzin Kalden, MSN, AGNP-C
• Denise Sharen Kawecki, FNP-C
• Clare Kelway, DIHOM NTP BHCN
• Douglas W Kennedy, OD
• Karen Kepart, R.N.
• Kerr Chiropractic Clinic PLC

• Oral & Maxillofacial Surgery (D.M.D.) in Erie, CO
• Providers in Erie, CO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.