Provider Demographics
NPI:1700105756
Name:H.K. DENTAL
Entity type:Organization
Organization Name:H.K. DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKCHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-961-9100
Mailing Address - Street 1:16224 CROCHERON AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1661
Mailing Address - Country:US
Mailing Address - Phone:718-961-9100
Mailing Address - Fax:718-961-9100
Practice Address - Street 1:16224 CROCHERON AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1661
Practice Address - Country:US
Practice Address - Phone:718-961-9100
Practice Address - Fax:718-961-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0525331223G0001X
NY0526091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty