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General NPI Number Information
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NPI Number | 1073697892
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Entity Type | Individual
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Provider Name | THOMAS C. KANG DDS
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2505 S 320TH ST SUITE 330
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5400
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Country | US
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Telephone | 206-400-0800
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Fax | 523-874-9068
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Provider Business Mailing Address
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Address Line | 2572 UNION AVE NE
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City | RENTON
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State | WA
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Zip | 98059-3501
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Country | US
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Telephone | 425-271-4120
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Fax | 253-874-0968
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | WA
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