Individual provider Active NPI

Yoonsun Lim Kang, DDS

  • Dentist
  • Duluth, GA
National Provider Identifier
1437720794
Registry record updated Jul 8, 2021
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN122404 Issued in GA
Practice address
1630 Pleasant Hill Rd Ste 200
Duluth, GA 30096-5828
Phone
(700) 381-7878
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN122404 GA Primary

Addresses

Primary practice location

1630 Pleasant Hill Rd Ste 200
Duluth, GA 30096-5828

Mailing address

1125 Hannaford LN
Johns Creek, GA 30097-6502
Phone (312) 965-0517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20211103000653 GA Order and Referring Only - DentistPractitioner - Dentist 5193113686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1437720794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 HANNAFORD LN",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300976502",
            "telephone_number": "312-965-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 PLEASANT HILL RD STE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965828",
            "telephone_number": "700-381-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "YOONSUN",
        "middle_name": "LIM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.