Provider Demographics
NPI:1043388051
Name:JUNG, SEI WOONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEI
Middle Name:WOONG
Last Name:JUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142-10AA ROOSEVELT AVENUE
Mailing Address - Street 2:#7
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-353-6852
Mailing Address - Fax:718-353-6852
Practice Address - Street 1:142-10AA ROOSEVELT AVENUE
Practice Address - Street 2:#7
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-353-6852
Practice Address - Fax:718-353-6852
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0341381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice