Provider Demographics
NPI:1609397538
Name:SEARINGTOWN DENTAL PC
Entity Type:Organization
Organization Name:SEARINGTOWN DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNGHWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-632-3132
Mailing Address - Street 1:140 LOCKWOOD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4907
Mailing Address - Country:US
Mailing Address - Phone:914-632-3132
Mailing Address - Fax:
Practice Address - Street 1:110 LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5028
Practice Address - Country:US
Practice Address - Phone:914-632-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052909261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02870946Medicaid