Provider Demographics
NPI:1225533037
Name:BYUN, YOUNGHYUP (DDS)
Entity Type:Individual
Prefix:
First Name:YOUNGHYUP
Middle Name:
Last Name:BYUN
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 1:410 E 20TH ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-8114
Mailing Address - Country:US
Mailing Address - Phone:646-300-3159
Mailing Address - Fax:
Practice Address - Street 1:1900 KRUCHTEN CT S STE 100
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4731
Practice Address - Country:US
Practice Address - Phone:320-656-1456
Practice Address - Fax:320-656-0195
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND139551223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics