Provider Demographics
NPI:1992184790
Name:CHRIS MYUNG DMD
Entity Type:Organization
Organization Name:CHRIS MYUNG DMD
Other - Org Name:CHRIS MYUNG DMD JINYOUNG SHIN DMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MYUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:310-543-3505
Mailing Address - Street 1:3480 TORRANCE BLVD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-543-3505
Mailing Address - Fax:
Practice Address - Street 1:3480 TORRANCE BLVD
Practice Address - Street 2:SUITE 221
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5808
Practice Address - Country:US
Practice Address - Phone:310-543-3505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty