Provider Demographics
NPI:1689006215
Name:JUNG, WOO SUNG (DDS)
Entity Type:Individual
Prefix:
First Name:WOO SUNG
Middle Name:
Last Name:JUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 W SLAUGHTER LN
Mailing Address - Street 2:#190
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5992
Mailing Address - Country:US
Mailing Address - Phone:512-593-4465
Mailing Address - Fax:
Practice Address - Street 1:2110 W SLAUGHTER LN
Practice Address - Street 2:#190
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5992
Practice Address - Country:US
Practice Address - Phone:512-593-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist