Provider Demographics
NPI:1427249580
Name:CHUNG L. HWANG, DDS, PLLC
Entity type:Organization
Organization Name:CHUNG L. HWANG, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUNG
Authorized Official - Middle Name:LONG
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PS
Authorized Official - Phone:253-850-1234
Mailing Address - Street 1:24837 104TH AVE SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030
Mailing Address - Country:US
Mailing Address - Phone:253-850-1234
Mailing Address - Fax:253-850-8393
Practice Address - Street 1:8412 MYERS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391
Practice Address - Country:US
Practice Address - Phone:253-826-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000072991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty