MEDICARE: TAMMY OUNG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	060548	NY

General Provider Information

NPI Number	:	1518464429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY OUNG DDS

Provider Business Mailing Address
First Line	:	1872 W 8TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2501
Country	:	US
Telephone Number	:	917-385-2652
Fax Number	:

Provider Business Practice Location Address
First Line	:	8686 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5119
Country	:	US
Telephone Number	:	718-714-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2018
Last Update Date	:	03/24/2021

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