Healthcare Provider Details

I. General information

NPI: 1760611974
Provider Name (Legal Business Name): YOUNGMO KANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10521 VALLEY VIEW ST
CYPRESS CA
90630-4832
US

IV. Provider business mailing address

10521 VALLEY VIEW ST
CYPRESS CA
90630-4832
US

V. Phone/Fax

Practice location:
  • Phone: 714-723-2035
  • Fax:
Mailing address:
  • Phone: 201-953-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number105409
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number105409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: