Provider Demographics
NPI:1942642855
Name:JUNG JIN LEEYOON INC
Entity Type:Organization
Organization Name:JUNG JIN LEEYOON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JUNG JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEEYOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-862-6525
Mailing Address - Street 1:10800 PARAMOUNT BLVD #207
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3331
Mailing Address - Country:US
Mailing Address - Phone:562-862-6525
Mailing Address - Fax:562-862-6526
Practice Address - Street 1:10800 PARAMOUNT BLVD #207
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3331
Practice Address - Country:US
Practice Address - Phone:562-862-6525
Practice Address - Fax:562-862-6526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty