Provider Demographics
NPI:1982276572
Name:HWANG, SEONG SIK (DDS)
Entity type:Individual
Prefix:DR
First Name:SEONG
Middle Name:SIK
Last Name:HWANG
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 1:26000 W LUGONIA AVE APT 4118
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-5111
Mailing Address - Country:US
Mailing Address - Phone:707-346-7046
Mailing Address - Fax:
Practice Address - Street 1:26910 NEWPORT RD STE B
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-9081
Practice Address - Country:US
Practice Address - Phone:951-679-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106501122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist