Provider Demographics
NPI:1811348840
Name:UNG, STEPHANIE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:UNG
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 1:15510 SONORA ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1936
Mailing Address - Country:US
Mailing Address - Phone:714-928-7626
Mailing Address - Fax:
Practice Address - Street 1:15510 SONORA ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1936
Practice Address - Country:US
Practice Address - Phone:714-928-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1011671223G0001X
OH30.0263971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice