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General NPI Number Information
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NPI Number | 1841435591
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Entity Type | Individual
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Provider Name | JIWON KANG DDS
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Gender | Male
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 410 CANYON ST
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City | PLAINVIEW
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State | TX
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Zip | 79072-7508
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Country | US
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Telephone | 806-291-0297
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Fax |
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Provider Business Mailing Address
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Address Line | RHN MEDICAL AND DENTAL GROUP 3113 ROSS ST
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City | AMARILLO
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State | TX
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Zip | 79118
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Country | US
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Telephone | 806-374-7341
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 27908
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License Number State | TX
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