Active NPI
Hyun Woo Kang
- Pediatric Dentistry
- New York, NY
National Provider Identifier
1487978086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 055039
- Practice address
- 244 Madison Ave
#6G
New York, NY 10016-2817 - Phone
- (917) 701-2142
- NPI assigned
- Mar 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 055039 | NY | Primary |
Addresses
Primary practice location
244 Madison Ave
#6G
New York, NY 10016-2817
Mailing address
244 Madison Ave
#6G
New York, NY 10016-2817
Phone (917) 701-2142
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119591300 | Medicaid | MD |
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Nov 28, 2016 through Nov 28, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055039 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1487978086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "244 MADISON AVE",
"address_2": "#6G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100162817",
"telephone_number": "917-701-2142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "244 MADISON AVE",
"address_2": "#6G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100162817",
"telephone_number": "917-701-2142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "HYUN WOO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-25",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "055039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119591300",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.