Provider Demographics
NPI:1720535362
Name:MYUNG, JANE (DDS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:MYUNG
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 1:201 SANSOME STREET UNIT 804
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCSICO
Mailing Address - State:CA
Mailing Address - Zip Code:94104
Mailing Address - Country:US
Mailing Address - Phone:415-933-9612
Mailing Address - Fax:
Practice Address - Street 1:201 SANSOME STREET UNIT 804
Practice Address - Street 2:
Practice Address - City:SAN FRANCSICO
Practice Address - State:CA
Practice Address - Zip Code:94104
Practice Address - Country:US
Practice Address - Phone:415-933-9612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1003841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice