Provider Demographics
NPI:1912316787
Name:JOSEPH HONG DDS & SUSANE LEE-HONG DDS, APC
Entity Type:Organization
Organization Name:JOSEPH HONG DDS & SUSANE LEE-HONG DDS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-243-7678
Mailing Address - Street 1:16264 VICTOR ST.
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3934
Mailing Address - Country:US
Mailing Address - Phone:760-243-7678
Mailing Address - Fax:760-243-7635
Practice Address - Street 1:16264 VICTOR ST.
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3934
Practice Address - Country:US
Practice Address - Phone:760-243-7678
Practice Address - Fax:760-243-7635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36085305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization