Mike Min W Kang, DDS., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45473 Issued in CA

Legal business name

MIKE MIN W KANG, DDS., INC.

Doing business as

CROWN DENTAL GROUP

Practice address

6907 La Tijera Blvd.
A
Los Angeles, CA 60045

Phone

(310) 645-0336

Fax

(310) 645-9250

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mike M K, DDS

Title

President

Phone

(310) 645-0336

Specialties & licenses 1

Addresses

Other names 1

• CROWN DENTAL GROUP Doing business as

Locations

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487867743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 LA TIJERA BLVD.",
            "address_2": "A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "60045",
            "telephone_number": "310-645-0336",
            "fax_number": "310-645-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 LA TIJERA BLVD.",
            "address_2": "A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "60045",
            "telephone_number": "310-645-0336",
            "fax_number": "310-645-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKE MIN W KANG, DDS., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "K",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-645-0336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CROWN DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Christine Mikhail

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.