Provider Demographics
NPI:1356681324
Name:JASON HONG, DDS & KATHY LAM, DDS, P.C.
Entity Type:Organization
Organization Name:JASON HONG, DDS & KATHY LAM, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-789-1555
Mailing Address - Street 1:700 E OGDEN AVE
Mailing Address - Street 2:SUIE 307
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5569
Mailing Address - Country:US
Mailing Address - Phone:630-789-1555
Mailing Address - Fax:630-789-9825
Practice Address - Street 1:700 E OGDEN AVE
Practice Address - Street 2:SUIE 307
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-5569
Practice Address - Country:US
Practice Address - Phone:630-789-1555
Practice Address - Fax:630-789-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty