Provider Demographics
NPI:1225215767
Name:CHIN, KYUNG HEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYUNG HEE
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N CENTRAL AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1938
Mailing Address - Country:US
Mailing Address - Phone:914-288-0880
Mailing Address - Fax:914-683-8419
Practice Address - Street 1:111 N CENTRAL AVE STE 260
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1938
Practice Address - Country:US
Practice Address - Phone:914-288-0880
Practice Address - Fax:914-683-8419
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0423361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice