Provider Demographics
NPI:1487348538
Name:CHUNG, JEANHEE (DMD)
Entity type:Individual
Prefix:DR
First Name:JEANHEE
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15409 TERRACE GREENE CIR
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22923-2897
Mailing Address - Country:US
Mailing Address - Phone:540-553-4994
Mailing Address - Fax:
Practice Address - Street 1:5690 THREE NOTCH D RD STE 100
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3173
Practice Address - Country:US
Practice Address - Phone:434-823-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist