Provider Demographics
NPI:1760841860
Name:ERICKSON AND HONG ORTHODONTICS, PC
Entity Type:Organization
Organization Name:ERICKSON AND HONG ORTHODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:301-236-0600
Mailing Address - Street 1:13321 NEW HAMPSHIRE AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3450
Mailing Address - Country:US
Mailing Address - Phone:301-236-0600
Mailing Address - Fax:
Practice Address - Street 1:13321 NEW HAMPSHIRE AVE STE 206
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-3450
Practice Address - Country:US
Practice Address - Phone:301-236-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 7215261QD0000X
MDMD 14419261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental