Provider Demographics
NPI:1356720767
Name:YOUNG JUN DDS MD INC
Entity type:Organization
Organization Name:YOUNG JUN DDS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:JUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-985-9690
Mailing Address - Street 1:601 E YORBA LINDA BLVD
Mailing Address - Street 2:9
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3006
Mailing Address - Country:US
Mailing Address - Phone:714-985-9690
Mailing Address - Fax:714-985-1762
Practice Address - Street 1:601 E YORBA LINDA BLVD
Practice Address - Street 2:9
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3006
Practice Address - Country:US
Practice Address - Phone:714-985-9690
Practice Address - Fax:714-985-1762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555131223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty