Provider Demographics
NPI:1518399062
Name:JUN, IN HYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:IN HYE
Middle Name:
Last Name:JUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:JUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2312 TUTTINGTON
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-3225
Mailing Address - Country:US
Mailing Address - Phone:405-808-6098
Mailing Address - Fax:
Practice Address - Street 1:2312 TUTTINGTON
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-3225
Practice Address - Country:US
Practice Address - Phone:405-808-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK65161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice