Provider Demographics
NPI:1558500025
Name:CHUN, JULIE MIN JUNG (RDH, BS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MIN JUNG
Last Name:CHUN
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MIN JUNG
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH, BS
Mailing Address - Street 1:4944 E SIESTA DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-0716
Mailing Address - Country:US
Mailing Address - Phone:951-809-2457
Mailing Address - Fax:
Practice Address - Street 1:4944 E SIESTA DR UNIT 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-0716
Practice Address - Country:US
Practice Address - Phone:951-809-2457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH010822124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist