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.

Practice address

1700 Pennsylvania Ave
Suite D
Fairfield, CA 94533-3588

Phone

(925) 336-9611

NPI assigned

Jun 1, 2016

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 identifiers 1

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL NPI",
            "identifier": "1972793651",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspring Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Jusinski, R.N.
• Kaiser Foundation Health Plan Inc
• 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.