Provider Demographics
NPI:1457707374
Name:CHON, ANDREW HUN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HUN
Last Name:CHON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6395 DOBBIN RD STE 208
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4759
Mailing Address - Country:US
Mailing Address - Phone:410-997-1189
Mailing Address - Fax:
Practice Address - Street 1:6395 DOBBIN RD STE 208
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4759
Practice Address - Country:US
Practice Address - Phone:410-997-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD173771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program