Provider Demographics
NPI:1336451806
Name:CHI, SUNG MEAN (DMD)
Entity type:Individual
Prefix:DR
First Name:SUNG MEAN
Middle Name:
Last Name:CHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANTHONY
Other - Middle Name:S
Other - Last Name:CHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:509 MADISON AVE STE 2100
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5501
Mailing Address - Country:US
Mailing Address - Phone:212-753-3723
Mailing Address - Fax:
Practice Address - Street 1:509 MADISON AVE STE 2100
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5501
Practice Address - Country:US
Practice Address - Phone:212-753-3723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-24889122300000X
NONE390200000X
NY0590311223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program