Minseok Kang, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

018001853 Issued in IL

Practice address

611 W Park St
Urbana, IL 61801-2500

Phone

(217) 326-1297

NPI assigned

Aug 2, 2012

Last updated

Aug 2, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1760738272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 PADDOCK DR W",
            "city": "SAVOY",
            "state": "IL",
            "postal_code": "618749625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-326-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MINSEOK",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "018001853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khushi Vishal Kalavadia
• Peter Kale, NP
• Barbara Kammer, M.D.
• Uday Bhaskar Kanakadandi, MD
• Kelly Ann Kane, PSYD
• Michael N Karras, M.D.
• Alexandra Katherine Kasapov, OTR/L
• Rehema N Kasasa
• Brent Kaufmann, MD
• Mariana Kawalet

• Oral and Maxillofacial Surgery (Dentist) in Urbana, IL
• Providers in Urbana, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.