Provider Demographics
NPI:1013125822
Name:YUN, JUNG S (DDS)
Entity type:Individual
Prefix:DR
First Name:JUNG
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 1:929 S MAIN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3364
Mailing Address - Country:US
Mailing Address - Phone:630-620-5888
Mailing Address - Fax:630-620-6149
Practice Address - Street 1:929 S MAIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3364
Practice Address - Country:US
Practice Address - Phone:630-620-5888
Practice Address - Fax:630-620-6149
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-21660122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist