Provider Demographics
NPI:1639334204
Name:CHUN, SERENA SZE-WING (DDS)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:SZE-WING
Last Name: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 1:911 MEDICAL CENTER PLZ STE 13
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-7816
Mailing Address - Country:US
Mailing Address - Phone:707-838-6697
Mailing Address - Fax:707-838-8678
Practice Address - Street 1:911 MEDICAL CENTER PLZ STE 13
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-7816
Practice Address - Country:US
Practice Address - Phone:707-838-6697
Practice Address - Fax:707-838-8678
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA546151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice