Provider Demographics
NPI:1487020723
Name:JASON K HONG, DMD, PC
Entity Type:Organization
Organization Name:JASON K HONG, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-798-4270
Mailing Address - Street 1:12359 SUNRISE VALLEY DR STE 250
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3494
Mailing Address - Country:US
Mailing Address - Phone:703-860-8613
Mailing Address - Fax:703-860-8615
Practice Address - Street 1:12359 SUNRISE VALLEY DR STE 250
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3494
Practice Address - Country:US
Practice Address - Phone:703-860-8613
Practice Address - Fax:703-860-8615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410505305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization