Provider Demographics
NPI:1306277934
Name:TUNG, CHRISTOPHER (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:TUNG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4090 N CHESTNUT AVE
Mailing Address - Street 2:APT 201
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4707
Mailing Address - Country:US
Mailing Address - Phone:206-856-1411
Mailing Address - Fax:
Practice Address - Street 1:16510 CLEVELAND ST
Practice Address - Street 2:SUITE Q
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4439
Practice Address - Country:US
Practice Address - Phone:425-882-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-08
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63125122300000X
WADE60417176122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist