Provider Demographics
NPI:1396767281
Name:BEGAYE, KYOON CHUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:KYOON
Middle Name:CHUNG
Last Name:BEGAYE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KYOON
Other - Middle Name:JA
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1570 REINDEER RDG
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3660
Mailing Address - Country:US
Mailing Address - Phone:770-781-9707
Mailing Address - Fax:
Practice Address - Street 1:2502 CHAMBLEE TUCKER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-3529
Practice Address - Country:US
Practice Address - Phone:770-457-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0112471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice