Individual provider Active NPI

Prairna Kang

  • General Practice Dentistry
  • Burlington, NC
National Provider Identifier
1952040230
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12938 Issued in NC
Practice address
139 Huffman Mill Rd Ste 104
Burlington, NC 27215-5112
Phone
(336) 261-3022
NPI assigned
Jun 3, 2022
Last updated
May 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61407738 WA
General Practice Dentistry 1223G0001X 12938 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

139 Huffman Mill Rd Ste 104
Burlington, NC 27215-5112

Mailing address

429 New Parkside Dr
Chapel Hill, NC 27516-1161
Phone (425) 598-4873

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230712004039 WA Order and Referring Only - DentistPractitioner - Dentist 3577923259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12938NCMDGeneral Practice Dentistry
61407738WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1952040230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 NEW PARKSIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161161",
            "telephone_number": "425-598-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 HUFFMAN MILL RD STE 104",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155112",
            "telephone_number": "336-261-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "PRAIRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61407738",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12938",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.