Provider Demographics
NPI:1376745398
Name:CHUNG, JOSEPH K (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:K
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:NY
Mailing Address - Zip Code:12775-0510
Mailing Address - Country:US
Mailing Address - Phone:845-796-3160
Mailing Address - Fax:845-796-3465
Practice Address - Street 1:230 ROCK HILL DRIVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:NY
Practice Address - Zip Code:12775
Practice Address - Country:US
Practice Address - Phone:845-796-3160
Practice Address - Fax:845-796-3465
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044771122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist