# CHI WHAN CHUNG DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568868693
- **Authorized official:** DR. CHI WHAN CHUNG DDS (DENTIST)
- **Authorized official phone:** (703) 273-8450

## Contact information

- **Practice address:** 3611 CHAIN BRIDGE RD STE B, FAIRFAX, VA 22030-3246
- **Practice address phone:** (703) 273-8450
- **Practice address fax:** (703) 649-6357
- **Mailing address:** 3611 CHAIN BRIDGE RD STE B, FAIRFAX, VA 22030-3246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401412213 | VA | Yes |

## Other

- **Enumeration date:** 11/18/2014
- **Last updated:** 11/18/2014