Healthcare Provider Details

I. General information

NPI: 1831478577
Provider Name (Legal Business Name): SARAH M KWANG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH KWANG D.D.S.

II. Dates (important events)

Enumeration Date: 08/12/2011
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17814 SPRING CYPRESS RD # 101
CYPRESS TX
77429-1719
US

IV. Provider business mailing address

1050 YALE ST STE 210
HOUSTON TX
77008-2831
US

V. Phone/Fax

Practice location:
  • Phone: 347-735-9105
  • Fax:
Mailing address:
  • Phone: 504-261-6682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number27407
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0000000
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: