Individual provider Active NPI

Christine Soojung Rhee, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1154773224
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
101957 Issued in CA
Practice address
8899 University Center LN Ste 190
San Diego, CA 92122-1035
Phone
(858) 546-0100
Fax
(858) 546-0495
NPI assigned
Jul 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 101957 CA Primary

Addresses

Primary practice location

8899 University Center LN Ste 190
San Diego, CA 92122-1035

Mailing address

8444 Via Sonoma Unit 89
La Jolla, CA 92037-2726
Phone (858) 519-2626

Other practice location 1

4424 Bonita Rd
Bonita, CA 91902-1423
Phone (619) 479-8703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20191016000651 CA Order and Referring Only - DentistPractitioner - Dentist 6507197951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101957CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abraham Tang DDS Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154773224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 VIA SONOMA UNIT 89",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920372726",
            "telephone_number": "858-519-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN STE 190",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221035",
            "telephone_number": "858-546-0100",
            "fax_number": "858-546-0495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4424 Bonita Rd",
            "address_purpose": "LOCATION",
            "city": "Bonita",
            "state": "CA",
            "postal_code": "919021423",
            "country_code": "US",
            "telephone_number": "619-479-8703",
            "fax_number": "619-479-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHEE",
        "first_name": "CHRISTINE",
        "middle_name": "SOOJUNG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.