Provider Demographics
NPI:1588341317
Name:CHUNG, SANG YOON (DMD)
Entity type:Individual
Prefix:DR
First Name:SANG YOON
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:KYLE SANG YOON
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:50 UNIVERSITY ST APT 616
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3253
Mailing Address - Country:US
Mailing Address - Phone:216-308-1846
Mailing Address - Fax:
Practice Address - Street 1:8012 112TH STREET CT E STE 320
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7856
Practice Address - Country:US
Practice Address - Phone:253-848-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61449684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist