Provider Demographics
NPI:1144319419
Name:JUNG, JOSEPH S (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:JUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5957 N DALLAS PKWY
Mailing Address - Street 2:#200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7822
Mailing Address - Country:US
Mailing Address - Phone:972-473-8000
Mailing Address - Fax:972-473-8006
Practice Address - Street 1:5957 N DALLAS PKWY
Practice Address - Street 2:#200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7822
Practice Address - Country:US
Practice Address - Phone:972-473-8000
Practice Address - Fax:972-473-8006
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist