Mo Kwan Kang, DDS, PHD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

51343 Issued in CA

Practice address

100 UCLA Medical PLZ
Suite 350
Los Angeles, CA 90095-0001

Phone

(310) 267-4241

Fax

(310) 208-0786

NPI assigned

May 17, 2007

Last updated

Jul 8, 2007By 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

Enrolled in CA

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• UCLA Grad Endo Clinic

  • Endodontics
  • Los Angeles, CA
  • NPI 1063630267
  Authorized official Same address or phone
• The Regents of the University of California

  dba Dental Practice UCLA Faculty Group

  • Pediatric Dentistry
  • Los Angeles, CA
  • NPI 1700978780

  Endodontics

  NPD (past)
• UCLA Faculty Group Dental Practice

  • Endodontics
  • Los Angeles, CA
  • NPI 1992163786
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770790594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "CHS 43-009",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-8048",
            "fax_number": "310-794-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ",
            "address_2": "SUITE 350",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-267-4241",
            "fax_number": "310-208-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MO",
        "middle_name": "KWAN",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "51343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyung Yi Kang, D.C
• Mark J Kang, MD
• Michael Kang, D.P.T.
• Michael C Kang, MD
• Min J Kang, OTR/L
• Moonsung Kang
• Myung Kang, NP-C
• Myung Jin Kang, ACUPUNCTURIST
• Myung Ki Kang
• Nayon Kang, LCSW

• Endodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.