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NPI Code Detail

MEDICARE: AMANDEEP KAUR KANG

MEDICARE: AMANDEEP KAUR KANG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019029084IL
21223G0001XGeneral Practice Dentistry019029084IL

General Provider Information

NPI Number : 1922362607
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDEEP KAUR KANG
Provider Business Mailing Address
First Line : 7247 SANDPIPER ST
Second Line :
City : PORTAGE
State : MI
Zip : 49024-7853
Country : US
Telephone Number : 269-599-7630
Fax Number :
Provider Business Practice Location Address
First Line : 3205 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3301
Country : US
Telephone Number : 773-267-2671
Fax Number : 773-267-2628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2012
Last Update Date : 06/27/2012

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Directions to “ AMANDEEP KAUR KANG ” Practice Location

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