Provider Demographics
NPI:1578673935
Name:HORNG, JULIE (DDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HORNG
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 1:2402 E 5TH ST UNIT 1717
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5174
Mailing Address - Country:US
Mailing Address - Phone:480-331-1522
Mailing Address - Fax:
Practice Address - Street 1:2402 E 5TH ST UNIT 1717
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5174
Practice Address - Country:US
Practice Address - Phone:480-331-1522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55824122300000X
AZD80111223D0004X
TX291761223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No122300000XDental ProvidersDentist