Provider Demographics
NPI:1366622177
Name:CHUNG, SARAH SEUNG-AH (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:SEUNG-AH
Last Name:CHUNG
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 1:2155 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2333
Mailing Address - Country:US
Mailing Address - Phone:415-929-6555
Mailing Address - Fax:415-749-3390
Practice Address - Street 1:2155 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2333
Practice Address - Country:US
Practice Address - Phone:415-929-6555
Practice Address - Fax:415-749-3390
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56131122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist