Provider Demographics
NPI:1497637268
Name:KANGIE ENTERPRISE CORPORATION
Entity type:Organization
Organization Name:KANGIE ENTERPRISE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-384-8713
Mailing Address - Street 1:4 PEDDLERS ROW # 65
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1525
Mailing Address - Country:US
Mailing Address - Phone:571-384-8713
Mailing Address - Fax:
Practice Address - Street 1:1520 BELLE VIEW BLVD # 5376
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-6530
Practice Address - Country:US
Practice Address - Phone:571-384-8713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty