Provider Demographics
NPI:1275860538
Name:YOUN, EUN JU (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUN JU
Middle Name:
Last Name:YOUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10407 LOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-4969
Mailing Address - Country:US
Mailing Address - Phone:909-544-2456
Mailing Address - Fax:
Practice Address - Street 1:1905 VALEWOOD ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-8526
Practice Address - Country:US
Practice Address - Phone:909-544-2456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice