Provider Demographics
NPI:1740964410
Name:WU, JUNYI (DMD)
Entity type:Individual
Prefix:
First Name:JUNYI
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13833 CEDAR RD APT 306
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2379
Mailing Address - Country:US
Mailing Address - Phone:858-228-7180
Mailing Address - Fax:
Practice Address - Street 1:5014 GRANDE SHOPS AVE
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-6786
Practice Address - Country:US
Practice Address - Phone:234-260-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027245122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist