Provider Demographics
NPI:1740490226
Name:LEEYOON, JUNG JIN (DDS)
Entity type:Individual
Prefix:MRS
First Name:JUNG JIN
Middle Name:
Last Name:LEEYOON
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 1:10800 PARAMOUNT BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3317
Mailing Address - Country:US
Mailing Address - Phone:562-862-6525
Mailing Address - Fax:
Practice Address - Street 1:10800 PARAMOUNT BLVD STE 207
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3317
Practice Address - Country:US
Practice Address - Phone:562-862-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice