Provider Demographics
NPI:1588845341
Name:CHUNG, YOUNG HOON (DMD)
Entity Type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:HOON
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 SUFFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-4210
Mailing Address - Country:US
Mailing Address - Phone:631-813-2008
Mailing Address - Fax:
Practice Address - Street 1:566 SUFFOLK AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4210
Practice Address - Country:US
Practice Address - Phone:631-813-2008
Practice Address - Fax:718-429-4821
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0536561122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist