Healthcare Provider Details

I. General information

NPI: 1043144926
Provider Name (Legal Business Name): HYOJUNG HONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 SALEM RD SW # 10
ROCHESTER MN
55902-4210
US

IV. Provider business mailing address

1482 WESTON RD
FARMERS BRANCH TX
75234-1319
US

V. Phone/Fax

Practice location:
  • Phone: 150-721-6586
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD15499
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: