Kyung Min Chung, D.M.D.
Individual provider Active NPI General Practice Dentistry · Hanscom Afb, MA
NPI 1053586339 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1053586339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22052 (MA)
- Practice address
- 90 Vandenberg Drive
Hanscom Afb, MA 01731 - Phone
- (781) 225-6324
- NPI assigned
- Apr 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22052 | MA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22052 | MA | Yes |
Addresses
Primary practice location
90 Vandenberg Drive
Hanscom Afb, MA 01731
Mailing address
90 Vandenberg Drive
Hanscom Afb, MA 01731
Phone (781) 225-6324
Other practice location 1
90 Vandenberg Dr
Hanscom AFB, MA 01731-2104
Phone (781) 225-6324
Other providers in Hanscom Afb, MA
- Manisa Bulsara
- Christine M Carino
- Caritas St Elizabeths Health Care
- Rebecca Charette
- John Choiniere
- Jay Scott Cloutier
- John F. Coke
- Sandra Elizabeth Colucci
- Callie Comstock
- Beverly A Dangelo
All providers in Hanscom Afb, MA · General Practice Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.