Samuel D. Kang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.031761 Issued in IL

Practice address

801 S Paulina St
Chicago, IL 60612-7210

Phone

(773) 770-5726

NPI assigned

Jun 23, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1730758749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 S WABASH AVE UNIT 1004",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052606",
            "telephone_number": "847-370-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "773-770-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "SAMUEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jieun Kang, MD
• Minnie Kang
• Paul Kang
• Priscilla Murphy Kang, LCSW
• Richard T Kang, DPT
• Sharon Kang, MD
• Soonmo Peter Kang, MD
• Tina Kang
• Yeram Kang, DDS
• Caren Kangas, BCBA

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.

Verify at the official NPI Registry.