Provider Demographics
NPI:1477039998
Name:YUN, JAE HYUK (DDS)
Entity Type:Individual
Prefix:
First Name:JAE HYUK
Middle Name:
Last Name:YUN
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 1:3939 BRIARGROVE LN APT 4204
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6341
Mailing Address - Country:US
Mailing Address - Phone:408-230-4541
Mailing Address - Fax:
Practice Address - Street 1:3939 BRIARGROVE LN APT 4204
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6341
Practice Address - Country:US
Practice Address - Phone:408-230-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34989122300000X
NV71001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice