Provider Demographics
NPI:1730211772
Name:CHAE, CHRISTOPHER PYUNGBAE (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PYUNGBAE
Last Name:CHAE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:PYUNGBAE
Other - Middle Name:
Other - Last Name:CHAE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9837 FOLSOM BLVD
Mailing Address - Street 2:J
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1356
Mailing Address - Country:US
Mailing Address - Phone:916-364-7111
Mailing Address - Fax:916-364-1040
Practice Address - Street 1:9837 FOLSOM BLVD
Practice Address - Street 2:J
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-364-7111
Practice Address - Fax:916-364-1040
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist