Kang, Hyo S. DMD Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56041 Issued in CA

Legal business name

KANG, HYO S. DMD INC.

Doing business as

Wellspring Dental Group

Practice address

1700 Pennsylvania Ave
Suite D
Fairfield, CA 94533-3588

Phone

(925) 336-9611

NPI assigned

Jun 1, 2016

Last updated

Jun 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Hyo S Kang, DMD

Title

President

Phone

(925) 336-9611

Specialties & licenses 1

Addresses

Other names 1

• Wellspring Dental Group Doing business as

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1548618580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8051 BRIAR OAKS DR",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945825196",
            "telephone_number": "925-336-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PENNSYLVANIA AVE",
            "address_2": "SUITE D",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333588",
            "telephone_number": "925-336-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANG, HYO S. DMD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "HYO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-336-9611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspring Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Jusinski, R.N.
• Kaiser Foundation Health Plan Inc (Kaiser Health Plan Mob Phy 401)
• Amadu Bubass Kamara
• Farhad Kandakloo, D.D.S
• Nikhita Kandikuppa Sharma
• Albert Deh-Zen Kao, PHARM.D.
• Yi Kao
• Krunali Kapadia
• Nancy L Kaplan, DPM
• Sudha Kapoor

• General Practice Dentistry in Fairfield, CA
• Providers in Fairfield, 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 Jun 1, 2016; 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.