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General NPI Number Information
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NPI Number | 1861901704
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Entity Type | Organization
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Legal Business Name | JAYNA L. CHUNG, D.D.S.
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 46-001 KAMEHAMCHA HWY SUITE 418
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City | KANEOHE
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State | HI
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Zip | 96744
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Country | US
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Telephone | 808-236-0216
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Fax | 808-236-7048
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Provider Business Mailing Address
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Address Line | 46-001 KAMEHAMCHA HWY SUITE #418
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City | KANEOHE
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State | HI
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Zip | 96744
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Country | US
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Telephone | 808-236-0216
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Fax | 808-236-7048
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Authorized Official
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Title or Position | OWNER
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Name | JAYNA LEI CHUNG
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Credential | D.D.S
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Telephone | 808-236-0216
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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 | DT1699
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License Number State | HI
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