Provider Demographics
NPI:1144707670
Name:JUNG, ASHLEE MEGAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLEE
Middle Name:MEGAN
Last Name:JUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:MEGAN
Other - Last Name:SUMILAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:303 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-9545
Mailing Address - Country:US
Mailing Address - Phone:909-793-8837
Mailing Address - Fax:
Practice Address - Street 1:303 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-9545
Practice Address - Country:US
Practice Address - Phone:909-793-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS102806122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist