Healthcare Provider Details

I. General information

NPI: 1184771248
Provider Name (Legal Business Name): YUN JOO HUYNH D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 TOWNE DR
ELIZABETHTOWN KY
42701-8466
US

IV. Provider business mailing address

12417 POPLAR WOODS DR
GOSHEN KY
40026-7742
US

V. Phone/Fax

Practice location:
  • Phone: 270-600-0096
  • Fax:
Mailing address:
  • Phone: 470-525-3967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number50092
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11268
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN015111
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: