Byeonguk Kang

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61077682 Issued in WA

Practice address

1959 NE Pacific St RM B403
Seattle, WA 98195-0001

Phone

(579) 720-6543

NPI assigned

Sep 29, 2020

Last updated

Sep 29, 2020By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1275140535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 AURORA AVE N APT 217",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092200",
            "telephone_number": "951-765-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST RM B403",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "579-720-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "BYEONGUK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61077682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Kanehen
• Jasmine Kaneshiro
• Angela Grace Kanevski, MA, LMHCA
• Maya Kaneyasu, ARNP
• Benjamin Kang, DDS
• Dahyeon Kang
• David Jungjoo Kang, DMD, MS, MMSC
• Edward Kang, PHARMD
• Gina Kang, M.D.
• Hannah Heayoung Kang, MS,CMC

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.