Provider Demographics
NPI:1477701829
Name:HONG, TOM (DDS)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:HONG
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 1:56 MARKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6051
Mailing Address - Country:US
Mailing Address - Phone:718-268-8629
Mailing Address - Fax:
Practice Address - Street 1:1075 CENTRAL PARK AVE STE 410
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3232
Practice Address - Country:US
Practice Address - Phone:914-725-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0513121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice