Provider Demographics
NPI:1225173198
Name:JAE H. MYUNG, D.D.S., P.C.
Entity Type:Organization
Organization Name:JAE H. MYUNG, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MYUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-261-9393
Mailing Address - Street 1:475 KINDERKAMACK ROAD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2259
Mailing Address - Country:US
Mailing Address - Phone:201-261-9393
Mailing Address - Fax:201-261-0943
Practice Address - Street 1:475 KINDERKAMACK ROAD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2259
Practice Address - Country:US
Practice Address - Phone:201-261-9393
Practice Address - Fax:201-261-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI157531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty