Provider Demographics
NPI:1437435203
Name:CHUN, LANI (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:LANI
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8544 S FAYEWAY DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-1309
Mailing Address - Country:US
Mailing Address - Phone:415-846-3259
Mailing Address - Fax:
Practice Address - Street 1:8544 S FAYEWAY DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-1309
Practice Address - Country:US
Practice Address - Phone:415-846-3259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482491223X0400X
UT4823929-99211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics