Jae Woo Chung, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

53122 Issued in CA

Practice address

27 Straw Flower
Irvine, CA 92620-1211

Phone

(714) 980-0967

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Better Choice Dental

  • Periodontics
  • Santa Ana, CA
  • NPI 1427556885
  NPD (past) Authorized official
• Erx Medical Clinic Inc

  • Neurological Surgery Physician
  • Van Nuys, CA
  • NPI 1528649555

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1043278153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 STRAW FLOWER",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201211",
            "telephone_number": "714-980-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 STRAW FLOWER",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201211",
            "telephone_number": "714-980-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JAE WOO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D009224",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "53122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daekwon Chung, DMD
• David Chung
• Emily Chung
• Grace Y. Chung, DNP, FNP-BC
• Haewon Chung, DDS
• Jim Y. Chung, D.C., L.AC.
• Joan Seonwha Chung, M.D.
• Justin Chung
• Su Young Chung
• Yu Chia Chung, RD

• Periodontics in Irvine, CA
• Providers in Irvine, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.