Provider Demographics
NPI:1598579435
Name:JAMES M CHUNG DDS PC
Entity type:Organization
Organization Name:JAMES M CHUNG DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-237-0662
Mailing Address - Street 1:313 PARK AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3303
Mailing Address - Country:US
Mailing Address - Phone:718-427-3972
Mailing Address - Fax:
Practice Address - Street 1:313 PARK AVE STE 302
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3303
Practice Address - Country:US
Practice Address - Phone:718-427-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401414355OtherVIRGINIA DEPT OF HEALTH PROFESSIONALS