Hyun Kyu Kang

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11541 Issued in CT

Practice address

1192 Farmington Ave
Bristol, CT 06010-4752

Phone

(860) 585-9000

NPI assigned

May 13, 2018

Last updated

May 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CT

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": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526169600000",
    "number": "1801386198",
    "addresses": [
        {
            "country_code": "KR",
            "country_name": "Korea, Republic of",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "BORAMAEKYUNGNAMHONORSVILLE APT 106-203",
            "address_2": "YOUNGDEUNGPOGU YEOUIDAEBANGRO 25",
            "city": "SEOUL",
            "state": "NA",
            "postal_code": "07437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104752",
            "telephone_number": "860-585-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "HYUN KYU",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-13",
        "last_updated": "2018-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Sacharko, Aprn LLC
• Susan Justice
• Donat Jutras, LO
• Manoja R Kanchumarthi, DDS
• Damira Kandic
• Justyna Kaniewski
• Jane M Kanowitz, MD
• Pallavi Krishna Karpe, DMD
• Christina Marie Kaschak, APRN
• Laith Kasir, M.D.

• General Practice Dentistry in Bristol, CT
• Providers in Bristol, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.

Verify at the official NPI Registry.