Provider Demographics
NPI:1134999196
Name:J&J FAMILY SMILES
Entity type:Organization
Organization Name:J&J FAMILY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JUNG AH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:213-222-3149
Mailing Address - Street 1:15201 E FREEWAY SERVICE RD.
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530
Mailing Address - Country:US
Mailing Address - Phone:281-860-2247
Mailing Address - Fax:
Practice Address - Street 1:15201 E FREEWAY SERVICE RD.
Practice Address - Street 2:SUITE 225
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530
Practice Address - Country:US
Practice Address - Phone:281-860-2247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty