Provider Demographics
NPI:1073353371
Name:HUNG, ELLEN KA LING (DDS)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:KA LING
Last Name:HUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3504
Mailing Address - Country:US
Mailing Address - Phone:831-252-6237
Mailing Address - Fax:
Practice Address - Street 1:4200 CALIFORNIA ST STE 210
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1367
Practice Address - Country:US
Practice Address - Phone:831-204-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1120491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice