Provider Demographics
NPI:1861880247
Name:KANG, JOHN JUNG HOON (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JUNG HOON
Last Name:KANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MARKET STREET
Mailing Address - Street 2:BSA #2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-3231
Mailing Address - Country:US
Mailing Address - Phone:215-564-9010
Mailing Address - Fax:215-261-5580
Practice Address - Street 1:2000 MARKET STREET
Practice Address - Street 2:BSA #2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-3231
Practice Address - Country:US
Practice Address - Phone:215-564-9010
Practice Address - Fax:215-261-5580
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025967001223G0001X
PADS0401861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice