Provider Demographics
NPI:1457764052
Name:CHEN, XUN JOY (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:XUN
Middle Name:JOY
Last Name:CHEN
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:DR
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD, MD
Mailing Address - Street 1:15005 SHADY GROVE RD STE 420
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6321
Mailing Address - Country:US
Mailing Address - Phone:301-762-0062
Mailing Address - Fax:
Practice Address - Street 1:15005 SHADY GROVE RD STE 420
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6321
Practice Address - Country:US
Practice Address - Phone:301-762-0062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD170881223S0112X
MDD00898601223S0112X
ZZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program