Provider Demographics
NPI:1194882746
Name:YUN, KYEONGJA CATHY (DDS)
Entity type:Individual
Prefix:DR
First Name:KYEONGJA
Middle Name:CATHY
Last Name:YUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KYEONGJA
Other - Middle Name:CATHY
Other - Last Name:YUN-CHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:6081 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2707
Mailing Address - Country:US
Mailing Address - Phone:703-538-2283
Mailing Address - Fax:703-538-2282
Practice Address - Street 1:6081 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2707
Practice Address - Country:US
Practice Address - Phone:703-538-2283
Practice Address - Fax:703-538-2282
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA68281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice