Provider Demographics
NPI:1285847582
Name:UNG, NANCY (DMD, MPH, MSD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:UNG
Suffix:
Gender:F
Credentials:DMD, MPH, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 EL TOYONAL
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2013
Mailing Address - Country:US
Mailing Address - Phone:925-258-6888
Mailing Address - Fax:925-258-6888
Practice Address - Street 1:441 JOAQUIN AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4997
Practice Address - Country:US
Practice Address - Phone:510-483-5524
Practice Address - Fax:510-483-4645
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA358121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics