Ji Won Kang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE61435599 Issued in WA

Practice address

4722 Fauntleroy Way SW Ste a
Seattle, WA 98116-4667

Phone

(206) 928-6242

NPI assigned

Aug 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jiwon Kang Other name

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

Practice roles

Locations

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.

• Washington Dental Corporation, PC

  dba Dentists of West Seattle

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1619635877
  NPD

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1891579090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13593 SW LIDEN DR",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232091",
            "telephone_number": "971-517-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4722 FAUNTLEROY WAY SW STE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164667",
            "telephone_number": "206-928-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JI",
        "middle_name": "WON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61435599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIWON",
            "last_name": "KANG",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Jungjoo Kang, DMD, MS, MMSC
• Edward Kang, PHARMD
• Gina Kang, M.D.
• Hannah Heayoung Kang, MS,CMC
• Ji Emily Kang
• John Kang, MD, PHD
• Kylie Haemin Kang, MD
• Michael Kang, DMD
• Michelle Kang
• Minjung Kang, N.D.

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.