Provider Demographics
NPI:1578906202
Name:RYAN O.Y. DUNG, D.D.S., INC.
Entity Type:Organization
Organization Name:RYAN O.Y. DUNG, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:OY
Authorized Official - Last Name:DUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-677-3601
Mailing Address - Street 1:94-229 WAIPAHU DEPOT ST
Mailing Address - Street 2:STE 303
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3031
Mailing Address - Country:US
Mailing Address - Phone:808-677-3601
Mailing Address - Fax:808-677-1577
Practice Address - Street 1:94-229 WAIPAHU DEPOT ST
Practice Address - Street 2:STE 303
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3031
Practice Address - Country:US
Practice Address - Phone:808-677-3601
Practice Address - Fax:808-677-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 1788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty