Provider Demographics
NPI:1063648228
Name:KIM CHUN, JOANNE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:M
Last Name:KIM 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 1:1731 CLARENDON BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2741
Mailing Address - Country:US
Mailing Address - Phone:703-812-8800
Mailing Address - Fax:703-812-8802
Practice Address - Street 1:1731 CLARENDON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-2741
Practice Address - Country:US
Practice Address - Phone:703-812-8800
Practice Address - Fax:703-812-8802
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014124511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice