Provider Demographics
NPI:1952852329
Name:JEON, HYERAN HELEN (DMD, MSD, DSCD)
Entity Type:Individual
Prefix:
First Name:HYERAN
Middle Name:HELEN
Last Name:JEON
Suffix:
Gender:F
Credentials:DMD, MSD, DSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W RITTENHOUSE SQ APT 2114
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5752
Mailing Address - Country:US
Mailing Address - Phone:215-898-4615
Mailing Address - Fax:
Practice Address - Street 1:240 S. 40TH STREET
Practice Address - Street 2:DENTAL @ LOCUST WALK
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-898-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARFD0000191223X0400X
VA04014150851223X0400X
PADS0435231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics