Healthcare Provider Details

I. General information

NPI: 1760365084
Provider Name (Legal Business Name): EUNICE HAEYOON WHANG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2025
Last Update Date: 07/26/2025
Certification Date: 07/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FERN ST. 8653
BAUMHOLDER RHEINLAND PFALZ
55774
DE

IV. Provider business mailing address

UNIT 33100 BOX LANDSTUHL
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 63-719-4641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019036022
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: