Healthcare Provider Details

I. General information

NPI: 1447155742
Provider Name (Legal Business Name): TAEWON TIMOTHY JUNG DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 N HILLVIEW DR
MILPITAS CA
95035-4544
US

IV. Provider business mailing address

824 N HILLVIEW DR
MILPITAS CA
95035-4544
US

V. Phone/Fax

Practice location:
  • Phone: 408-262-0510
  • Fax: 408-262-0709
Mailing address:
  • Phone: 408-262-0510
  • Fax: 408-262-0709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: TAEWON JUNG
Title or Position: OWNER
Credential: DDS
Phone: 408-262-0510