Su Jung Kang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416999 Issued in VA

Practice address

5275 Leesburg Pike Building 7
Suite 100
Falls Church, VA 22041

Phone

(703) 935-2878

NPI assigned

Jul 14, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1902414105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12362 AZURE LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332991",
            "telephone_number": "703-304-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 LEESBURG PIKE BUILDING 7",
            "address_2": "SUITE 100",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22041",
            "telephone_number": "703-935-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "SU JUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Kang
• Ellison C Kang
• Heannie Yoo Kang, MD
• Joo Young Kang, MD
• Min Hee Kang, CRNP
• Collins F Kankam, MD
• Geoffrey S Kannan, PH.D., M.D.
• Sumeeta Kantak, MD
• Shreya M Kanth, MD
• Aminata Kanu

• General Practice Dentistry in Falls Church, VA
• Providers in Falls Church, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.