Provider Demographics
NPI:1427249556
Name:CHUNG, ANNA SEUNG-EUN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:SEUNG-EUN
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 1:4141 STATE ST STE C2
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1852
Mailing Address - Country:US
Mailing Address - Phone:805-696-1002
Mailing Address - Fax:
Practice Address - Street 1:4141 STATE ST STE C2
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1852
Practice Address - Country:US
Practice Address - Phone:805-696-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55901122300000X, 1223G0001X
IA086091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAFC0494877OtherDEA