Provider Demographics
NPI:1235989088
Name:HUR, JOSEPH JEONG-GYUN (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JEONG-GYUN
Last Name:HUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 BOND ST APT 535
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2045
Mailing Address - Country:US
Mailing Address - Phone:714-822-7003
Mailing Address - Fax:
Practice Address - Street 1:2149 BARRACKS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4810
Practice Address - Country:US
Practice Address - Phone:434-424-0285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03035600122300000X
VA0401419378122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist