Provider Demographics
NPI:1811198633
Name:HUNG, STEPHEN (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:HUNG
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 1:2460 LEMOINE AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6231
Mailing Address - Country:US
Mailing Address - Phone:201-947-3777
Mailing Address - Fax:201-947-3710
Practice Address - Street 1:2460 LEMOINE AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6231
Practice Address - Country:US
Practice Address - Phone:201-947-3777
Practice Address - Fax:201-947-3710
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01891300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist