Healthcare Provider Details
I. General information
NPI: 1356280010
Provider Name (Legal Business Name): SOO KANG DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
218 MAIN ST STE 4
HACKENSACK NJ
07601-7325
US
IV. Provider business mailing address
218 MAIN ST STE 4
HACKENSACK NJ
07601-7325
US
V. Phone/Fax
- Phone: 201-820-3600
- Fax:
- Phone: 201-820-3600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SOO
R
KANG
Title or Position: PRESIDENT
Credential: DDS
Phone: 201-820-3600