Tae Hyung Kang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D10675 Issued in OR

Practice address

8400 NE Vancouver Mall Loop
Vancouver, WA 98662-6671

Phone

(360) 450-6639

NPI assigned

Jul 19, 2017

Last updated

Aug 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tigard Modern Dentistry and Orthodontics, PC

  dba Tigard Modern Dentistry

  • General Practice Dentistry
  • Tigard, OR
  • NPI 1649640434

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1407379639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14954 NW OLIVE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297020",
            "telephone_number": "503-901-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 NE VANCOUVER MALL LOOP",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626671",
            "telephone_number": "360-450-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12266 SW Scholls Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972233354",
            "country_code": "US",
            "telephone_number": "503-455-8483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "TAE HYUNG",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60760032",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imogen Kane
• Kevin Michael Kane
• Cassidy Dawn Kang-Toone
• Harleen Kang, NP
• Simranjit Kang, MD
• Paul Louis Kangas
• Joyc Ann Kania, M.S.W.
• Joseph Michael Kann, PA-C
• Joshua Kannankeril
• Jennifer Kanooth

• Dentist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dentist in Washington

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