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General NPI Number Information
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NPI Number | 1952896417
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Entity Type | Individual
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Provider Name | SHAWN SEOK-HUN JUNG
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Gender | Male
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 7240 E POINT DOUGLAS RD S STE 150
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-3021
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Country | US
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Telephone | 651-352-4628
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Fax |
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Provider Business Mailing Address
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Address Line | 6901 FLYING CLOUD DR APT 212
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-4706
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Country | US
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Telephone | 630-445-3994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.031676
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | FJ8407795
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License Number State | MN
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