Provider Demographics
NPI:1720375629
Name:KANG, HYEJUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:HYEJUNG
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 N MACLAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-1328
Mailing Address - Country:US
Mailing Address - Phone:818-898-1388
Mailing Address - Fax:
Practice Address - Street 1:4332 KISSENA BLVD
Practice Address - Street 2:#8V/1
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2934
Practice Address - Country:US
Practice Address - Phone:347-324-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist