Provider Demographics
NPI:1598918146
Name:TUNG, DIANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:TUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19270 AURORA AVE N
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-853-7173
Mailing Address - Fax:206-800-7791
Practice Address - Street 1:19270 AURORA AVE N
Practice Address - Street 2:SUITE #2
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-800-7790
Practice Address - Fax:206-800-7791
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA600415481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry