Provider Demographics
NPI:1467643478
Name:MYUNG & CHUNG DENTAL CORPORATION
Entity Type:Organization
Organization Name:MYUNG & CHUNG DENTAL CORPORATION
Other - Org Name:DOWNEY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-803-3333
Mailing Address - Street 1:8102 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3604
Mailing Address - Country:US
Mailing Address - Phone:562-803-3333
Mailing Address - Fax:562-803-3666
Practice Address - Street 1:8102 3RD ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3604
Practice Address - Country:US
Practice Address - Phone:562-803-3333
Practice Address - Fax:562-803-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44037122300000X
CA40799122300000X
CA445251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
902715OtherUNITED CONCORDIA