Healthcare Provider Details

I. General information

NPI: 1346986239
Provider Name (Legal Business Name): HYUN-DO JOO, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12621 HERO WAY WEST SUITE B10
LEANDER TX
78641-7871
US

IV. Provider business mailing address

13500 LYNDHURST ST APT 3021
AUSTIN TX
78717-6097
US

V. Phone/Fax

Practice location:
  • Phone: 323-337-4301
  • Fax:
Mailing address:
  • Phone: 132-333-7430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. HYUN-DO JOO
Title or Position: CEO
Credential: DDS
Phone: 323-337-4301