Brett Myungsoo Chung, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025437 Issued in IL

Practice address

4175 S. Alamo Ave
Davis-Monthan Afb, AZ 85707-4405

Phone

(520) 228-2792

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1124249990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S. ALAMO AVE",
            "city": "DAVIS-MONTHAN AFB",
            "state": "AZ",
            "postal_code": "85707",
            "telephone_number": "520-228-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S. ALAMO AVE",
            "city": "DAVIS-MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074405",
            "telephone_number": "520-228-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "BRETT",
        "middle_name": "MYUNGSOO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-11-02",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53494",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett G Brazier, DO
• Michael David Brewer, MD
• Patricia Ann Bridges, RPH
• Diamond Byrd
• Justin Chiasson, IDMT
• Jayme L Cline, IDMT
• Amanda Cook, DO
• Jason West Cromar, M.D., M.P.H.
• Angela C. Demaio, LCSW, LISAC
• Joel David Drallette, DO

• General Practice Dentistry in Davis-Monthan Afb, AZ
• Providers in Davis-Monthan Afb, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.