Michael Chung, D.D.S., M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

64035 Issued in CA

Practice address

360 E Las Tunas Dr Ste 206
San Gabriel, CA 91776-5514

Phone

(818) 768-2062

NPI assigned

Nov 20, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 7, 2025 through Oct 7, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1154795656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E LAS TUNAS DR STE 206",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765514",
            "telephone_number": "818-780-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E LAS TUNAS DR STE 206",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765514",
            "telephone_number": "818-768-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-20",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64034",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "64034",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "64035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Chung
• James Chung, O.D.
• Jenny Chen Chung, DDS
• Johnson Ling-Hung Chung, DMD
• Ling-Ling Chung, PRH
• City of San Gabriel
• Christina Co, PA-C
• Ethan Co, DDS
• Edward S Colby, M.D.
• Comfort Dental

• Oral & Maxillofacial Surgery (D.M.D.) in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.