Provider Demographics
NPI:1710663141
Name:KUNG, AVA (DDS)
Entity Type:Individual
Prefix:
First Name:AVA
Middle Name:
Last Name:KUNG
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 1:4200 N CHAI ST APT 1210
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0556
Mailing Address - Country:US
Mailing Address - Phone:408-791-9997
Mailing Address - Fax:
Practice Address - Street 1:1449 W DURANTA AVE STE A
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-2328
Practice Address - Country:US
Practice Address - Phone:956-232-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX39972122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program