Provider Demographics
NPI:1649491077
Name:YUN, HYUN SOO (DDS INC)
Entity type:Individual
Prefix:
First Name:HYUN
Middle Name:SOO
Last Name:YUN
Suffix:
Gender:M
Credentials:DDS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14135 FRANCISQUITO AVE
Mailing Address - Street 2:#107
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-6107
Mailing Address - Country:US
Mailing Address - Phone:626-814-0259
Mailing Address - Fax:626-814-2129
Practice Address - Street 1:14135 FRANCISQUITO AVE
Practice Address - Street 2:#107
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-6107
Practice Address - Country:US
Practice Address - Phone:626-814-0259
Practice Address - Fax:626-814-2129
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA-50551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist