Healthcare Provider Details

I. General information

NPI: 1033759139
Provider Name (Legal Business Name): HELLO DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 BELMONT AVE
HALEDON NJ
07508-1407
US

IV. Provider business mailing address

237 CEDAR LN
CLOSTER NJ
07624-1138
US

V. Phone/Fax

Practice location:
  • Phone: 973-942-5515
  • Fax:
Mailing address:
  • Phone: 347-563-5530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: YOO JIN SHIN
Title or Position: PARTNER
Credential: DDS
Phone: 973-942-5515