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NPI Code Detail

MEDICARE: REEN CHUNG DDS PLLC

MEDICARE: REEN CHUNG DDS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1881047470
Entity Type Code : Organization
Provider Name (Legal Business Name) : REEN CHUNG DDS PLLC
Provider Business Mailing Address
First Line : 11227 ROOSEVELT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98125-6225
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11227 ROOSEVELT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98125-6225
Country : US
Telephone Number : 206-362-6838
Fax Number : 206-362-1299
Authorized Official
Title or Position : OWNER
Name : REEN CHUNG
Credential :
Telephone Number : 661-889-6916
Provider Enumeration Date : 07/19/2016
Last Update Date : 07/19/2016

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