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General NPI Number Information
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NPI Number | 1144736125
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Entity Type | Organization
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Legal Business Name | JUN CHEONG DDS, INCORPORATION
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 1007 W LA PALMA AVE STE 3
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City | ANAHEIM
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State | CA
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Zip | 92801-3620
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Country | US
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Telephone | 714-778-6160
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 W LA PALMA AVE STE 3
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City | ANAHEIM
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State | CA
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Zip | 92801-3620
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Country | US
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Telephone | 714-778-6160
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | DAYE JANG
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Credential |
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Telephone | 213-568-9681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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