Provider Demographics
NPI:1932113693
Name:CHUNG, CHI-KI ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHI-KI ANDREW
Middle Name:
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 1:90 W CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-6847
Mailing Address - Country:US
Mailing Address - Phone:518-344-5360
Mailing Address - Fax:
Practice Address - Street 1:90 W CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12306-6847
Practice Address - Country:US
Practice Address - Phone:518-344-5360
Practice Address - Fax:518-344-5362
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047442-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist