Provider Demographics
NPI:1851502504
Name:BRIAN Y HONG DENTAL CORPORATION
Entity type:Organization
Organization Name:BRIAN Y HONG DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDD, MS
Authorized Official - Phone:213-383-5437
Mailing Address - Street 1:2789 W OLYMPIC BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2268
Mailing Address - Country:US
Mailing Address - Phone:213-383-5437
Mailing Address - Fax:213-383-5775
Practice Address - Street 1:2789 W OLYMPIC BLVD STE 301
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2268
Practice Address - Country:US
Practice Address - Phone:213-383-5437
Practice Address - Fax:213-383-5775
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIAN Y HONG DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-24
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3733501Medicare UPIN