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General NPI Number Information
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NPI Number | 1922482785
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Entity Type | Individual
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Provider Name | JUSTIN KANG DMD, MS, MPH
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Gender | Male
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Dates
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Enumeration Date | 07/11/2015
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 321 BROAD AVE BUILDING F5
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City | RIDGEFIELD
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State | NJ
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Zip | 07657-2346
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Country | US
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Telephone | 201-313-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 185 FAIRFIELD AVE STE 1B
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-6417
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Country | US
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Telephone | 973-228-2335
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI 02602500
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License Number State | NJ
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