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Organization
TINA JUNG DDS MS
Active
Organization
TINA JUNG DDS MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA JUNG DDS (OWNER DENTIST)
(213) 335-6366
Entity
Organization
Contact information
Practice address
10921 WILSHIRE BLVD STE 407, LOS ANGELES, CA 90024-4001
(213) 335-6366
Mailing address
10921 WILSHIRE BLVD STE 407, LOS ANGELES, CA 90024-4001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDS64530
DENTAL LICENSE
CA
Enumeration date
09/27/2023
Last updated
09/27/2023
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