Provider Demographics
NPI:1902794027
Name:HALCYON PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:HALCYON PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OHKYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:678-648-7000
Mailing Address - Street 1:4080 MCGINNIS FERRY RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-1736
Mailing Address - Country:US
Mailing Address - Phone:678-648-7000
Mailing Address - Fax:770-971-3046
Practice Address - Street 1:4080 MCGINNIS FERRY RD STE 201
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-1736
Practice Address - Country:US
Practice Address - Phone:678-648-7000
Practice Address - Fax:770-971-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty