Healthcare Provider Details

I. General information

NPI: 1851690184
Provider Name (Legal Business Name): JOHN J HONG D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 E ELDER ST STE 203
FALLBROOK CA
92028-3083
US

IV. Provider business mailing address

521 E ELDER ST STE 203
FALLBROOK CA
92028-3083
US

V. Phone/Fax

Practice location:
  • Phone: 760-626-0077
  • Fax:
Mailing address:
  • Phone: 760-626-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS044888
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02464400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number101233
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number056328
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: