Provider Demographics
NPI:1851690184
Name:HONG, JOHN J (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:HONG
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 1:57 W. 57TH ST.
Mailing Address - Street 2:SUITE 1414
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-752-8431
Mailing Address - Fax:212-752-9718
Practice Address - Street 1:57 W. 57TH ST.
Practice Address - Street 2:SUITE 1414
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-752-8431
Practice Address - Fax:212-752-9718
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02464400122300000X
NY056328122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist