Provider Demographics
NPI:1457932790
Name:YUN, JULIA HAYOUNG (DDS)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:HAYOUNG
Last Name:YUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PARK AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3769
Mailing Address - Country:US
Mailing Address - Phone:253-293-6515
Mailing Address - Fax:
Practice Address - Street 1:140 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2810
Practice Address - Country:US
Practice Address - Phone:845-580-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028845001223G0001X
CADDS1074181223G0001X
390200000X
NY0627121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program