Provider Demographics
NPI:1053478859
Name:CHUN, MARILYN BJ (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:BJ
Last Name:CHUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-800 KAHAEA PL
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-2770
Mailing Address - Country:US
Mailing Address - Phone:808-488-0191
Mailing Address - Fax:
Practice Address - Street 1:1000 KAMEHAMEHA HWY
Practice Address - Street 2:#235
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2881
Practice Address - Country:US
Practice Address - Phone:808-456-5953
Practice Address - Fax:808-455-4453
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 2108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist