Provider Demographics
NPI:1194905117
Name:YONG, RICHARD JUNG (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JUNG
Last Name:YONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E LINCOLN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3202
Mailing Address - Country:US
Mailing Address - Phone:714-535-0192
Mailing Address - Fax:714-535-7494
Practice Address - Street 1:101 E LINCOLN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3202
Practice Address - Country:US
Practice Address - Phone:714-535-0192
Practice Address - Fax:714-535-7494
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA475911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice