Provider Demographics
NPI:1487408670
Name:DEBORAH CHUNG, D.D.S., PLLC
Entity type:Organization
Organization Name:DEBORAH CHUNG, D.D.S., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-818-0007
Mailing Address - Street 1:5730 UNION MILL RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-1088
Mailing Address - Country:US
Mailing Address - Phone:703-818-0007
Mailing Address - Fax:
Practice Address - Street 1:5730 UNION MILL RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-1088
Practice Address - Country:US
Practice Address - Phone:804-517-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental