Provider Demographics
NPI:1114449907
Name:CHUNG, HYO JUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HYO JUNG
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HYO
Other - Middle Name:JUNG
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:493 LA CONNER DR APT 4
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-5721
Mailing Address - Country:US
Mailing Address - Phone:408-470-8352
Mailing Address - Fax:
Practice Address - Street 1:1672 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1235
Practice Address - Country:US
Practice Address - Phone:408-272-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DR031581223G0001X
CA1029661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice