Active NPI
Su Tong Kang, DDS
- Dentist
- Louisville, KY
National Provider Identifier
1871581157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7336
- Practice address
- 7405A New Lagrange Road
Louisville, KY 40222-4049 - Phone
- (502) 425-6021
- Fax
- (502) 412-0077
- NPI assigned
- Oct 11, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | 7336 | KY | Primary |
Addresses
Primary practice location
7405A New Lagrange Road
Louisville, KY 40222-4049
Mailing address
7405A New Lagrange Road
Louisville, KY 40222-4049
Phone (502) 425-6021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7336 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585180800000",
"number": "1871581157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7405A NEW LAGRANGE ROAD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402224049",
"telephone_number": "502-425-6021",
"fax_number": "502-412-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7405A NEW LAGRANGE ROAD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402224049",
"telephone_number": "502-425-6021",
"fax_number": "502-412-0077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "SU",
"middle_name": "TONG",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2020-03-26",
"certification_date": "2020-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "7336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.