Samuel Kang

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

061211 Issued in NY

Practice address

2110 Northern Blvd Ste 206
Manhasset, NY 11030-3500

Phone

(516) 627-7888

NPI assigned

Mar 2, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

Practice roles

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.

• Friendly Smile Dental Care PLLC

  • Multi-Specialty Clinic/Center
  • Flushing, NY
  • NPI 1043168388
  NPD Authorized official
• Manhasset Dental, P.C.

  • General Practice Dentistry
  • Manhasset, NY
  • NPI 1932579869
  NPD (past)

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

{
    "created_epoch": "1551484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1184182727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 NORTHERN BLVD STE 206",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 NORTHERN BLVD STE 206",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303500",
            "telephone_number": "516-627-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-3076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-02",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priyanush Kandakatla, MD
• Yakov Kandov, M.D.
• Fallon Kane, PH.D
• Naomi S Kane, MA
• Gurjaipaul Kang
• Rula Venus Kanj, MD
• Lawrence J Kanner, MD
• Deborah R Kaplan, LCSW
• Jeremy David Kaplitt, MD
• Michael Dimitrios Karachalios, M.D.

• General Practice Dentistry in Manhasset, NY
• Providers in Manhasset, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.