Provider Demographics
NPI:1174189906
Name:HONG, DAVID JIOONG (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JIOONG
Last Name:HONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:JEE
Other - Middle Name:WOONG
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:601 US HIGHWAY 206 UNIT 30
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1522
Mailing Address - Country:US
Mailing Address - Phone:908-359-0666
Mailing Address - Fax:
Practice Address - Street 1:601 US HIGHWAY 206 UNIT 30
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1522
Practice Address - Country:US
Practice Address - Phone:908-359-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI028041001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program