Provider Demographics
NPI:1205481256
Name:HONG, JENNY HONG (DDS, MSC)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:HONG
Last Name:HONG
Suffix:
Gender:F
Credentials:DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3067
Mailing Address - Country:US
Mailing Address - Phone:267-879-0797
Mailing Address - Fax:
Practice Address - Street 1:110 HARDEN PKWY STE 102
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-5257
Practice Address - Country:US
Practice Address - Phone:831-540-2195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice