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General NPI Number Information
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NPI Number | 1326513144
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Entity Type | Individual
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Provider Name | PEI JUNG CHUNG
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 15514 MERIDIAN E
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City | PUYALLUP
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State | WA
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Zip | 98375-9513
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Country | US
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Telephone | 253-268-1215
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Fax |
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Provider Business Mailing Address
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Address Line | 10605 LA RODA DR
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City | CUPERTINO
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State | CA
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Zip | 95014-4430
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Country | US
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Telephone | 408-838-7888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 102068
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D012333
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60740109
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License Number State | WA
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