Active NPI
Anna Kang
- General Practice Dentistry
- Stamford, CT
National Provider Identifier
1104419506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13743
- Practice address
- 75 Tresser Blvd
Stamford, CT 06901-3329 - Phone
- (203) 883-9986
- NPI assigned
- Feb 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13743 | CT | Primary |
Addresses
Primary practice location
75 Tresser Blvd
Stamford, CT 06901-3329
Mailing address
3 Moorland Dr
Danbury, CT 06810-1513
Other practice location 1
3 Moorland Dr
Danbury, CT 06810-1513
Phone (203) 482-8088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13743 | CT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1104419506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 MOORLAND DR",
"city": "DANBURY",
"state": "CT",
"postal_code": "068101513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 TRESSER BLVD",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069013329",
"telephone_number": "203-883-9986"
}
],
"practiceLocations": [
{
"address_1": "3 Moorland Dr",
"address_purpose": "LOCATION",
"city": "Danbury",
"state": "CT",
"postal_code": "068101513",
"country_code": "US",
"telephone_number": "203-482-8088",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KANG",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-16",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "13743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.