Provider Demographics
NPI:1952660474
Name:SOHN, PAUL JUNGWAN (DDS, MMSC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JUNGWAN
Last Name:SOHN
Suffix:
Gender:M
Credentials:DDS, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-2312
Mailing Address - Country:US
Mailing Address - Phone:917-715-6299
Mailing Address - Fax:
Practice Address - Street 1:282 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-1260
Practice Address - Country:US
Practice Address - Phone:201-345-3892
Practice Address - Fax:201-345-3893
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02658300122300000X, 1223P0700X
NY058636122300000X
MADN18563911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice