Healthcare Provider Details

I. General information

NPI: 1346943313
Provider Name (Legal Business Name): YOORIM KANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 ADAMS ST
HOBOKEN NJ
07030-3391
US

IV. Provider business mailing address

727 ADAMS ST
HOBOKEN NJ
07030-3391
US

V. Phone/Fax

Practice location:
  • Phone: 120-147-9275
  • Fax:
Mailing address:
  • Phone: 201-479-2752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number22DI03150800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: