Provider Demographics
NPI:1477957850
Name:JI, JUNG HUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUNG HUN
Middle Name:
Last Name:JI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JUNGHUN
Other - Middle Name:
Other - Last Name:JI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:19731 S HIGHWAY 213
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4190
Mailing Address - Country:US
Mailing Address - Phone:503-518-3384
Mailing Address - Fax:503-518-3385
Practice Address - Street 1:19731 S HIGHWAY 213
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4190
Practice Address - Country:US
Practice Address - Phone:503-518-3384
Practice Address - Fax:503-518-3385
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64039122300000X
NV6580122300000X
ORD10382122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist