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General NPI Number Information
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NPI Number | 1518534239
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Entity Type | Individual
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Provider Name | ERIC BYEON
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 55 OLD GATE LN
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City | MILFORD
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State | CT
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Zip | 06460-3612
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Country | US
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Telephone | 203-878-6699
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Fax |
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Provider Business Mailing Address
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Address Line | 11811 VENICE BLVD APT 113
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City | LOS ANGELES
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State | CA
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Zip | 90066-3928
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Country | US
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Telephone | 323-250-6388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14054
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 107586
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License Number State | CA
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