Provider Demographics
NPI:1205827482
Name:YANG, SEUNG HYUK (DMD)
Entity Type:Individual
Prefix:DR
First Name:SEUNG
Middle Name:HYUK
Last Name:YANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 UNION ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2200
Mailing Address - Country:US
Mailing Address - Phone:718-321-2885
Mailing Address - Fax:718-321-2802
Practice Address - Street 1:2950 UNION ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2200
Practice Address - Country:US
Practice Address - Phone:718-321-2885
Practice Address - Fax:718-321-2802
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02156081Medicaid