Provider Demographics
NPI:1922130459
Name:YUN, SAMUEL S (DDS)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:S
Last Name:YUN
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 1:225 OAK SPRINGS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2105
Mailing Address - Country:US
Mailing Address - Phone:540-347-0274
Mailing Address - Fax:
Practice Address - Street 1:225 OAK SPRINGS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2105
Practice Address - Country:US
Practice Address - Phone:540-347-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010061971223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery