Provider Demographics
NPI:1962780817
Name:JUNG, YUN JOO (DDS)
Entity type:Individual
Prefix:
First Name:YUN JOO
Middle Name:
Last Name:JUNG
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 1:15200 SHADY GROVE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3218
Mailing Address - Country:US
Mailing Address - Phone:301-330-9644
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 105
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:301-330-9644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16736122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist