Provider Demographics
NPI:1891871216
Name:CHUN, DARRELL SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:SCOTT
Last Name:CHUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9381 E. STOCKTON BLVD
Mailing Address - Street 2:SUITE 228
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624
Mailing Address - Country:US
Mailing Address - Phone:916-691-1188
Mailing Address - Fax:916-691-1122
Practice Address - Street 1:9381 E. STOCKTON BLVD
Practice Address - Street 2:SUITE 228
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624
Practice Address - Country:US
Practice Address - Phone:916-691-1188
Practice Address - Fax:916-691-1122
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39773122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist