Healthcare Provider Details

I. General information

NPI: 1326805177
Provider Name (Legal Business Name): JENNA YU CHUN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 S RIVER RD
BEDFORD NH
03110-6759
US

IV. Provider business mailing address

55 STATION LNDG APT 521
MEDFORD MA
02155-5055
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number05374
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: