Provider Demographics
NPI:1710362546
Name:WOO, KYUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:
Last Name:WOO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2611
Mailing Address - Country:US
Mailing Address - Phone:551-298-3878
Mailing Address - Fax:
Practice Address - Street 1:472 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2611
Practice Address - Country:US
Practice Address - Phone:904-412-1479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02777800122300000X
FLDN21478122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist