Provider Demographics
NPI:1447551155
Name:YOUN, ALEXIS BUNHONG (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:BUNHONG
Last Name:YOUN
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 1:2 E ERIE ST
Mailing Address - Street 2:APT 3901
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2724
Mailing Address - Country:US
Mailing Address - Phone:734-604-1271
Mailing Address - Fax:312-322-6881
Practice Address - Street 1:1844 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:312-322-6882
Practice Address - Fax:312-322-6881
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028790122300000X
MI29010202681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice