Provider Demographics
NPI:1982817367
Name:YUNG, JOHANN JUERGEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHANN
Middle Name:JUERGEN
Last Name:YUNG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NEWBURY RD.,
Mailing Address - Street 2:SUITE 290
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320
Mailing Address - Country:US
Mailing Address - Phone:805-499-8880
Mailing Address - Fax:805-499-8883
Practice Address - Street 1:1000 NEWBURY RD
Practice Address - Street 2:SUITE 290
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6435
Practice Address - Country:US
Practice Address - Phone:805-499-8880
Practice Address - Fax:805-499-8883
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice