Justin Dongyoon Chung

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61649816 Issued in WA

Practice address

600 Orondo Ave
Wenatchee, WA 98801-2800

Phone

(509) 662-6000

NPI assigned

May 7, 2024

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 WA

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

Interoperability endpoints

• Direct secure messaging: justin.chung.1@10575.direct.athenahealth.com

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1124876974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 BURCH HOLLOW LN",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988015605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Othello",
            "state": "WA",
            "postal_code": "993441846",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JUSTIN",
        "middle_name": "DONGYOON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-07",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61649816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Joseph Christensen, DDS, MD
• Ivan Christensen, D.C.
• David Christiansen, DMD
• Taylor Chulawat
• Alyssa Chung, PAC
• Jeffrey P. Chvilicek, MD
• Debra Anne Ciarlo, SLP, LMHC
• Phil Cibicki, CPC
• Jesenia Cifuentes
• Andrea Clark, NP

• General Practice Dentistry in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.