Provider Demographics
NPI:1881842383
Name:BYUN, JASON J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:J
Last Name:BYUN
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 1:5024 194TH STREET SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4707
Mailing Address - Country:US
Mailing Address - Phone:206-680-0108
Mailing Address - Fax:
Practice Address - Street 1:5024 194TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5449
Practice Address - Country:US
Practice Address - Phone:206-680-0108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60035280122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist