Active NPI
Paul Kang, DDS
- Dentist
- Marshalltown, IA
National Provider Identifier
1720498249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 09464
- Practice address
- 112 E Linn St
Marshalltown, IA 50158-2901 - Phone
- (641) 844-6230
- Fax
- (641) 844-6235
- NPI assigned
- May 6, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 09464 | IA | Primary |
Addresses
Primary practice location
112 E Linn St
Marshalltown, IA 50158-2901
Mailing address
1200 University Ave Ste 200
Des Moines, IA 50314-2355
Phone (515) 248-1447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160803000247 | CT | Order and Referring Only - Dentist | 7719271493 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09464 | IA | MD | Dentist |
| 11554 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541721600000",
"number": "1720498249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 UNIVERSITY AVE STE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503142355",
"telephone_number": "515-248-1447",
"fax_number": "515-248-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 E LINN ST",
"city": "MARSHALLTOWN",
"state": "IA",
"postal_code": "501582901",
"telephone_number": "641-844-6230",
"fax_number": "641-844-6235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "PAUL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-06",
"last_updated": "2018-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "09464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshalltown, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.