Provider Demographics
NPI:1215137310
Name:WON, WOOJUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:WOOJUNG
Middle Name:
Last Name:WON
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 1:19402 NORTHERN BLVD STE LL1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3006
Mailing Address - Country:US
Mailing Address - Phone:347-368-4237
Mailing Address - Fax:
Practice Address - Street 1:19402 NORTHERN BLVD STE LL1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3006
Practice Address - Country:US
Practice Address - Phone:347-368-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist