Hyunseok Charlie CHI, DDS, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6902 Issued in NV

Practice address

640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086

Phone

(702) 399-3800

NPI assigned

Jul 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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.

• Shahrestani Deer Springs Modern Dentistry, PC

  • Dentist
  • North Las Vegas, NV
  • NPI 1922351931
  NPD (past)

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1124258736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 ELLINGTON PARK ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666049",
            "telephone_number": "702-589-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E DEER SPRINGS WAY STE 180",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89086",
            "telephone_number": "702-399-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "CMR 454 Box 1114",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "092500012",
            "country_code": "US",
            "telephone_number": "491719379979",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "CHI",
        "first_name": "HYUNSEOK",
        "middle_name": "CHARLIE",
        "name_prefix": "Dr.",
        "credential": "DDS, DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29610",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57861",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18605",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamekia Cherry
• Patricia Chess
• Garett Kwok Shing Cheung
• Kody Shun-Wing Venturina Cheung
• Qandeel Fatimah Chevalwala, RBT
• Adrian Mark Chia
• Ginger Yin Chiang, M.D.
• Geoffrey F. Chiara, O.D.
• Children and Adolescents Mentoring Services,LLC
• Hernoria Pal Lea Childress-Smith

• General Practice Dentistry in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.