MEDICARE: WILLIAM SEHEE JEONG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	22DI03051300	NJ
2	122300000X	Dentist	DS044719	PA

General Provider Information

NPI Number	:	1114551660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SEHEE JEONG DDS

Provider Business Mailing Address
First Line	:	235 GARFIELD AVE APT D
Second Line	:
City	:	COLLINGSWOOD
State	:	NJ
Zip	:	08108-3819
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 PACKER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-4910
Country	:	US
Telephone Number	:	215-618-9070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2020
Last Update Date	:	07/23/2024

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Directions to “ WILLIAM SEHEE JEONG DDS” Practice Location

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