Provider Demographics
NPI:1538056601
Name:HWANG, SEUNGJOON
Entity type:Individual
Prefix:
First Name:SEUNGJOON
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 W LEXINGTON ST APT 31G
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1553
Mailing Address - Country:US
Mailing Address - Phone:281-507-8042
Mailing Address - Fax:
Practice Address - Street 1:6100 DAYLONG LN STE 204
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1655
Practice Address - Country:US
Practice Address - Phone:667-200-5912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD186531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice