Provider Demographics
NPI:1700290566
Name:ROY CHUN, DDS, PA
Entity Type:Organization
Organization Name:ROY CHUN, DDS, PA
Other - Org Name:OASIS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-781-7725
Mailing Address - Street 1:5340 EL PASO DR
Mailing Address - Street 2:SUITE K
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2837
Mailing Address - Country:US
Mailing Address - Phone:915-781-7725
Mailing Address - Fax:915-779-3387
Practice Address - Street 1:5340 EL PASO DR
Practice Address - Street 2:SUITE K
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2837
Practice Address - Country:US
Practice Address - Phone:915-781-7725
Practice Address - Fax:915-779-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25057122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty