Provider Demographics
NPI:1174696546
Name:KANG, SUNG H (DDS)
Entity type:Individual
Prefix:
First Name:SUNG
Middle Name:H
Last Name:KANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18100 HAYLOFT DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-1668
Mailing Address - Country:US
Mailing Address - Phone:301-990-7218
Mailing Address - Fax:
Practice Address - Street 1:2390 GLENMONT CIR
Practice Address - Street 2:109
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1347
Practice Address - Country:US
Practice Address - Phone:301-949-1149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice