Provider Demographics
NPI:1730273319
Name:KANG, JEAN H (DDS)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:H
Last Name:KANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 PLAINSBORO ROAD
Mailing Address - Street 2:SUITE 608
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536
Mailing Address - Country:US
Mailing Address - Phone:609-799-7427
Mailing Address - Fax:609-799-7428
Practice Address - Street 1:666 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 608
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536
Practice Address - Country:US
Practice Address - Phone:609-799-7427
Practice Address - Fax:609-799-7428
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1021100001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics