Provider Demographics
NPI:1114226784
Name:HWANG, EUN SUN (DDS)
Entity Type:Individual
Prefix:
First Name:EUN
Middle Name:SUN
Last Name:HWANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10365 JASON RYAN PL
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3577
Mailing Address - Country:US
Mailing Address - Phone:240-483-9918
Mailing Address - Fax:
Practice Address - Street 1:23076 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-2442
Practice Address - Country:US
Practice Address - Phone:240-483-9918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14615122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist