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1790340875 NPI number — KIM & WANG DDS PLLC

NPI Number: 1790340875
Health Care Provider/Practitioner: KIM & WANG DDS PLLC

Information about “1790340875” NPI (KIM & WANG DDS PLLC) exists in 1790340875 in HTML format HTML  |  1790340875 in plain Text format TXT  |  1790340875 in PDF (Portable Document Format) PDF  |  1790340875 in an XML format XML  formats.

NPI Number : 1790340875 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790340875",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KIM & WANG DDS PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "107-37 71ST AVE",
    "SecondLineMailingAddress": "SUITE 203, MAILBOX #4",
    "MailingAddressCityName": "FOREST HILLS",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11375",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-261-1432",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10737 71ST AVE STE 203",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FOREST HILLS",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11375-4736",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-261-1432",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/05/2019",
    "LastUpdateDate": "05/05/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WANG",
    "AuthorizedOfficialFirstName": "HOWARD",
    "AuthorizedOfficialMiddleName": "HAO",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "646-705-4908",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223E0200X",
          "TaxonomyName": "Endodontics",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223P0300X",
          "TaxonomyName": "Periodontics",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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