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General NPI Number Information
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NPI Number | 1417846171
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Entity Type | Organization
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Legal Business Name | SEUNG MIN JUNG DDS, INC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 15890 GALE AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-1601
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Country | US
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Telephone | 626-333-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 35 WINDWARD WAY
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City | BUENA PARK
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State | CA
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Zip | 90621-1683
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Country | US
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Telephone | 718-710-1275
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | SEUNG MIN JUNG
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Credential |
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Telephone | 718-710-1275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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