Healthcare Provider Details

I. General information

NPI: 1598095911
Provider Name (Legal Business Name): YOON EUY HONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14936 NORTHERN BLVD #201
FLUSHING NY
11354-3845
US

IV. Provider business mailing address

14936 NORTHERN BLVD #201
FLUSHING NY
11354-3845
US

V. Phone/Fax

Practice location:
  • Phone: 718-888-9446
  • Fax: 718-888-9447
Mailing address:
  • Phone: 718-888-9446
  • Fax: 718-888-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number053338
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: