Provider Demographics
NPI:1215167069
Name:YU, JUNG H (DDS)
Entity type:Individual
Prefix:DR
First Name:JUNG
Middle Name:H
Last Name:YU
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 1:3910 PASO DEL LAGOS
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-4904
Mailing Address - Country:US
Mailing Address - Phone:949-466-7074
Mailing Address - Fax:
Practice Address - Street 1:3910 PASO DEL LAGOS
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-4904
Practice Address - Country:US
Practice Address - Phone:949-466-7074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583801223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry