Provider Demographics
NPI:1023207727
Name:OH, STELLA KYUNG SEOK (DDS)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:KYUNG SEOK
Last Name:OH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KYUNG SEOK
Other - Middle Name:
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:159 E 30TH ST
Mailing Address - Street 2:# 16A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7300
Mailing Address - Country:US
Mailing Address - Phone:646-382-8443
Mailing Address - Fax:
Practice Address - Street 1:660 KINDERKAMACK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1525
Practice Address - Country:US
Practice Address - Phone:201-634-9400
Practice Address - Fax:201-634-9488
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI022157001223P0700X
NY0527461223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics