Provider Demographics
NPI:1215051420
Name:BYUN, CHONGHWAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHONGHWAN
Middle Name:
Last Name:BYUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:EUGUNE
Other - Middle Name:C
Other - Last Name:BYUN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2413
Mailing Address - Country:US
Mailing Address - Phone:201-569-1213
Mailing Address - Fax:201-461-2650
Practice Address - Street 1:3 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2413
Practice Address - Country:US
Practice Address - Phone:201-569-1213
Practice Address - Fax:201-461-2650
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI166311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice