Provider Demographics
NPI:1396065306
Name:OUNG, PUCHNAN (DDS)
Entity type:Individual
Prefix:DR
First Name:PUCHNAN
Middle Name:
Last Name:OUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:OUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4122 TRAVIS ST
Mailing Address - Street 2:UNIT 13
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1856
Mailing Address - Country:US
Mailing Address - Phone:214-417-5450
Mailing Address - Fax:
Practice Address - Street 1:1417 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-1501
Practice Address - Country:US
Practice Address - Phone:972-870-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice