Provider Demographics
NPI:1952681991
Name:YANG, JUNG HOON JASON (DDS)
Entity Type:Individual
Prefix:
First Name:JUNG HOON
Middle Name:JASON
Last Name:YANG
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 1:490 2ND AVE
Mailing Address - Street 2:16C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9156
Mailing Address - Country:US
Mailing Address - Phone:646-964-8409
Mailing Address - Fax:
Practice Address - Street 1:490 2ND AVE
Practice Address - Street 2:16C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9156
Practice Address - Country:US
Practice Address - Phone:646-964-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055760122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist