Provider Demographics
NPI:1508134842
Name:HWANG, SOOKIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOOKIE
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 STATE RT 23 STE 1
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457-1625
Mailing Address - Country:US
Mailing Address - Phone:973-831-2901
Mailing Address - Fax:862-377-0775
Practice Address - Street 1:51 STATE RT 23 STE 1
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1625
Practice Address - Country:US
Practice Address - Phone:973-831-2901
Practice Address - Fax:862-377-0775
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024848001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice