Healthcare Provider Details

I. General information

NPI: 1932943495
Provider Name (Legal Business Name): JUNG EUN YOON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3123 JOHN F. KENNEDY BLVD
NORTH BERGEN NJ
07047
US

IV. Provider business mailing address

255 BRUNSWICK ST APT 314
JERSEY CITY NJ
07302-1592
US

V. Phone/Fax

Practice location:
  • Phone: 201-662-0662
  • Fax:
Mailing address:
  • Phone: 617-412-8307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number07535
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03025100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: