Provider Demographics
NPI:1598268419
Name:JU DDS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JU DDS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAKYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:JU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-293-0373
Mailing Address - Street 1:899 ADAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2235
Mailing Address - Country:US
Mailing Address - Phone:702-293-0373
Mailing Address - Fax:702-293-3464
Practice Address - Street 1:899 ADAMS BLVD
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2235
Practice Address - Country:US
Practice Address - Phone:702-293-0373
Practice Address - Fax:702-293-3464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV67301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty