Individual provider Active NPI

Justin Kang, DMD, MS, MPH

  • Dentist
  • Ridgefield, NJ
National Provider Identifier
1922482785
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI 02602500 Issued in NJ
Practice address
321 Broad Ave
Building F5
Ridgefield, NJ 07657-2346
Phone
(201) 313-2277
NPI assigned
Jul 11, 2015
Last updated
Jan 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI 02602500 NJ Primary

Addresses

Primary practice location

321 Broad Ave
Building F5
Ridgefield, NJ 07657-2346

Mailing address

185 Fairfield Ave Ste 1B
West Caldwell, NJ 07006-6417
Phone (973) 228-2335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20191030000279 NJ Order and Referring Only - DentistPractitioner - Dentist 2365774049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22DI 02602500NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sway Dental & Facial Esthetics LLC CurrentSince Jan 19, 2025 Accepting new patients

Locations

300 North Ave E
Cranford, NJ 07016
Phone (908) 276-2244

185 Fairfield Ave
Ste 1B
West Caldwell, NJ 07006
Phone (973) 228-2335

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1436572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1922482785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 FAIRFIELD AVE STE 1B",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066417",
            "telephone_number": "973-228-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BROAD AVE",
            "address_2": "BUILDING F5",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076572346",
            "telephone_number": "201-313-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-11",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI 02602500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, NJ

Sources for this page

Verify at the official NPI Registry.