Provider Demographics
NPI:1063178572
Name:SHI, CHUNING (DDS)
Entity type:Individual
Prefix:DR
First Name:CHUNING
Middle Name:
Last Name:SHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13208 MOONLIGHT TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6711
Mailing Address - Country:US
Mailing Address - Phone:443-570-0567
Mailing Address - Fax:
Practice Address - Street 1:409 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5227
Practice Address - Country:US
Practice Address - Phone:443-570-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PADS043764122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program