Provider Demographics
NPI:1134477458
Name:HYUN, SEUNG JOON (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEUNG
Middle Name:JOON
Last Name:HYUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:SEUNG
Other - Last Name:HYUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11899 DEL AMO BLVD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7605
Mailing Address - Country:US
Mailing Address - Phone:562-402-4411
Mailing Address - Fax:562-606-0119
Practice Address - Street 1:11899 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:562-402-4411
Practice Address - Fax:562-606-0119
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA616591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice