Provider Demographics
NPI:1184756934
Name:JEONG, YOUJIN NATALIE (DMD)
Entity type:Individual
Prefix:DR
First Name:YOUJIN
Middle Name:NATALIE
Last Name:JEONG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:Y
Other - Last Name:JEONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:160 LINCOLN RD
Mailing Address - Street 2:P.O. BOX 262
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773
Mailing Address - Country:US
Mailing Address - Phone:781-259-1600
Mailing Address - Fax:781-259-1601
Practice Address - Street 1:160 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773
Practice Address - Country:US
Practice Address - Phone:781-259-1600
Practice Address - Fax:781-259-1601
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200741223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics