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General NPI Number Information
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NPI Number | 1679182125
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Entity Type | Individual
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Provider Name | JUNHYUNG AN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 297 BOSTON POST RD
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City | ORANGE
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State | CT
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Zip | 06477-3537
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Country | US
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Telephone | 203-204-3180
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 166TH ST FL 2
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City | WHITESTONE
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State | NY
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Zip | 11357-2273
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Country | US
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Telephone | 917-698-7040
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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 | 12825
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License Number State | CT
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