Provider Demographics
NPI:1851838619
Name:HWANG, JI YOUNG (DMD)
Entity Type:Individual
Prefix:MRS
First Name:JI YOUNG
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 S TRIVIZ DR ACCESS DENTAL & ORTHODONTICS
Mailing Address - Street 2:STE 130/140
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001
Mailing Address - Country:US
Mailing Address - Phone:595-522-1983
Mailing Address - Fax:
Practice Address - Street 1:1748 S TRIVIZ DR ACCESS DENTAL & ORTHODONTICS
Practice Address - Street 2:STE 130/140
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001
Practice Address - Country:US
Practice Address - Phone:595-522-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32604122300000X
NMDD5658122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist