Healthcare Provider Details

I. General information

NPI: 1255252417
Provider Name (Legal Business Name): MODERN DENTAL NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 EAGLE ROCK AVE STE B
WEST ORANGE NJ
07052-3637
US

IV. Provider business mailing address

464 EAGLE ROCK AVE STE B
WEST ORANGE NJ
07052-3637
US

V. Phone/Fax

Practice location:
  • Phone: 973-324-9999
  • Fax: 973-731-4444
Mailing address:
  • Phone: 973-324-9999
  • Fax: 973-731-4444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: YOUNGMAN CHUN
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 973-324-9999