Provider Demographics
NPI:1194845149
Name:HUH, JUNG EUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUNG
Middle Name:EUN
Last Name:HUH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:HUH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1111 RIVER RD
Mailing Address - Street 2:B4
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1335
Mailing Address - Country:US
Mailing Address - Phone:267-230-8344
Mailing Address - Fax:
Practice Address - Street 1:475 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2664
Practice Address - Country:US
Practice Address - Phone:973-423-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0368761223G0001X
NY0529701223G0001X
NJ22DI023352001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0281578Medicaid