NPIMap

Organization Active NPI

SJ Kang Dental One, PLLC

  • General Practice Dentistry
  • Grand Prairie, TX
National Provider Identifier
1891492021
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SJ KANG DENTAL ONE, PLLC
Practice address
1017 Fort Worth St Ste 100
Grand Prairie, TX 75050-5404
Phone
(469) 827-7554
NPI assigned
Feb 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Dr. Hojoong Ryu, DDSNPI 1710327614
Title
Managing Member
Phone
(469) 827-7554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1017 Fort Worth St Ste 100
Grand Prairie, TX 75050-5404

Mailing address

1017 Fort Worth St Ste 100
Grand Prairie, TX 75050-5404
Phone (469) 827-7554

Other names 1

  • Estrella Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1891492021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 FORT WORTH ST STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505404",
            "telephone_number": "469-827-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 FORT WORTH ST STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505404",
            "telephone_number": "469-827-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ KANG DENTAL ONE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "RYU",
        "authorized_official_first_name": "HOJOONG",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "469-827-7554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Estrella Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Estrella Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.