Provider Demographics
NPI:1366173379
Name:KAHNG, HAHNGOO JUSTIN (DDS)
Entity type:Individual
Prefix:DR
First Name:HAHNGOO
Middle Name:JUSTIN
Last Name:KAHNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 S PEGASUS WAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-4520
Mailing Address - Country:US
Mailing Address - Phone:425-785-5458
Mailing Address - Fax:
Practice Address - Street 1:3707 N CANYON RD STE 2A
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4525
Practice Address - Country:US
Practice Address - Phone:801-997-5875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12904283-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist