Individual
SE-YOUNG JEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5130 DUKE ST STE 4, ALEXANDRIA, VA 22304-2955
(703) 370-6500
Mailing address
4160 CALAIS POINT CT, FAIRFAX, VA 22033-6200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416390
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2017
Last updated
07/01/2021
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