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General NPI Number Information
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NPI Number | 1780441196
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Entity Type | Individual
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Provider Name | TZU-HAN CHUNG
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1514 COORS BLVD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87121-1105
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Country | US
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Telephone | 505-257-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 9100 SAN MATEO BLVD NE APT 3014
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2606
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Country | US
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Telephone | 520-336-6605
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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 | DB-2025-0185
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License Number State | NM
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