Provider Demographics
NPI:1528632296
Name:JUNG, ARIEE (DMD)
Entity type:Individual
Prefix:
First Name:ARIEE
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5170 BUTLER ST APT 5
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2603
Mailing Address - Country:US
Mailing Address - Phone:201-407-8683
Mailing Address - Fax:
Practice Address - Street 1:4328 OLD WILLIAM PENN HWY STE LI
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1496
Practice Address - Country:US
Practice Address - Phone:412-373-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PADS043123122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program