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General NPI Number Information
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NPI Number | 1346961208
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Entity Type | Individual
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Provider Name | SARA KAHNG DDS
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Gender | Female
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 801 S PAULINA ST RM 130C
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City | CHICAGO
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State | IL
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Zip | 60612-7210
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Country | US
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Telephone | 312-996-7505
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Fax |
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Provider Business Mailing Address
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Address Line | 19 N MORGAN ST # W1109
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City | CHICAGO
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State | IL
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Zip | 60607-2681
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Country | US
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Telephone | 818-312-3291
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DDS106094
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License Number State | CA
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