Healthcare Provider Details

I. General information

NPI: 1982852612
Provider Name (Legal Business Name): JAMES JINWOOK CHUN D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2008
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 ELLINGTON BLVD
GAITHERSBURG MD
20878-4552
US

IV. Provider business mailing address

120 ELLINGTON BLVD
GAITHERSBURG MD
20878-4552
US

V. Phone/Fax

Practice location:
  • Phone: 301-987-0600
  • Fax:
Mailing address:
  • Phone: 301-987-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401411022
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: