Active NPI
Kinneth Chong, DDS
- Dentist
- Ellicott City, MD
National Provider Identifier
1154599587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9448
- Practice address
- 3444 Ellicott Center Dr
Ste104
Ellicott City, MD 21043-4170 - Phone
- (410) 461-4345
- NPI assigned
- Feb 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9448 | MD | Primary |
Addresses
Primary practice location
3444 Ellicott Center Dr
Ste104
Ellicott City, MD 21043-4170
Mailing address
3444 Ellicott Center Dr Ste 104
Ellicott City, MD 21043-4670
Phone (410) 461-4345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9448 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1154599587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3444 ELLICOTT CENTER DR STE 104",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434670",
"telephone_number": "410-461-4345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3444 ELLICOTT CENTER DR",
"address_2": "STE104",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434170",
"telephone_number": "410-461-4345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHONG",
"first_name": "KINNETH",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-19",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "9448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.