Provider Demographics
NPI:1821777202
Name:JUNG, SEUNG WON (DDS)
Entity type:Individual
Prefix:
First Name:SEUNG WON
Middle Name:
Last Name:JUNG
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 1:35 PANGBORN PL
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:212-998-9800
Mailing Address - Fax:
Practice Address - Street 1:345 E. 24TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-998-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2025-09-11
Deactivation Date:2024-02-20
Deactivation Code:
Reactivation Date:2025-09-11
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03108000122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program