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General NPI Number Information
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NPI Number | 1609439033
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Entity Type | Organization
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Legal Business Name | BENJAMIN KANG, DDS, PHD, PLLC
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 4500 SAND POINT WAY NE STE 212
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City | SEATTLE
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State | WA
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Zip | 98105-3925
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Country | US
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Telephone | 206-524-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 5091 BUCKLEY DR
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City | YPSILANTI
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State | MI
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Zip | 48197-6815
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Country | US
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Telephone | 562-900-9182
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | BENJAMIN KANG
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Credential | DDS
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Telephone | 562-900-9182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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