IndividualActive
Chan Young Moon
NPI 1326733379 · Orofacial Pain Dentistry · Seocho-Gu
Provider details
- NPI number
- 1326733379
- Entity type
- Individual
- Primary specialty
- Orofacial Pain DentistryDental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 0401418565 (VA)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
13 Seochodaero
B1 101 Ho, Moon'S Dental Clinic
Seocho-Gu, 06569
Mailing address
13 Seochodaero
Seocho-Gu, SEOUL 06569
Additional practice locations (2)
- 1 Kneeland StBoston, MA 02111-1527Phone: (617) 636-6828
- 3801 Fairfax Dr Ste 24Arlington, VA 22203-1762Phone: (703) 988-7278
Registry dates
- Enumerated
- 2023-04-06
- Last updated
- 2026-04-15
- Certified
- 2026-04-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.