Jean Kang

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS103652 Issued in CA

Practice address

1808 Verdugo Blvd Ste 312
Glendale, CA 91208-1456

Phone

(818) 790-6721

NPI assigned

Apr 7, 2017

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Jean Kang, D.D.S., Inc.

  dba The Tickled Tooth

  • Pediatric Dentistry
  • Glendale, CA
  • NPI 1336971126
  NPD Authorized official

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1932632726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 BRUNSWICK AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391201",
            "telephone_number": "909-618-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD STE 312",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081456",
            "telephone_number": "818-790-6721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1427 Mission St",
            "address_purpose": "LOCATION",
            "city": "South Pasadena",
            "state": "CA",
            "postal_code": "910303213",
            "country_code": "US",
            "telephone_number": "626-403-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 W Sierra Madre Blvd",
            "address_purpose": "LOCATION",
            "city": "Sierra Madre",
            "state": "CA",
            "postal_code": "910242492",
            "country_code": "US",
            "telephone_number": "626-325-3750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2023-03-07",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS103652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "103652",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Kampe
• Sirisin Kamsut, MD
• Kamyar Ebrahimi MD Apc
• Brian D Kan, M.D.
• Teru Judy Kanazawa, LCSW
• Ani Kanian
• Noune Kanousian Sarkisyan, B.A
• Frank Hyman Kanovsky, M.D.
• Kartik Kansagra
• Wendy C Kao, PA-C

• Pediatric Dentistry in Glendale, CA
• Providers in Glendale, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.