MEDICARE: DR. JUNG-MEE HWANG D.M.D

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	0401415372	VA
2	1223G0001X	General Practice Dentistry	0401415372	VA

General Provider Information

NPI Number	:	1578794277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUNG-MEE HWANG D.M.D

Provider Business Mailing Address
First Line	:	46169 WESTLAKE DR STE 330
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-5875
Country	:	US
Telephone Number	:	703-444-5111
Fax Number	:

Provider Business Practice Location Address
First Line	:	46169 WESTLAKE DR STE 330
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-5875
Country	:	US
Telephone Number	:	703-444-5111
Fax Number	:

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

Provider Enumeration Date	:	07/30/2009
Last Update Date	:	11/17/2020

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