Active NPI
Choon Chung, DDS
- Dentist
- Ashley, PA
National Provider Identifier
1194807750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS036908
- Practice address
- 117 N Main St
Ashley, PA 18706-2323 - Phone
- (570) 824-1009
- Fax
- (570) 824-1037
- NPI assigned
- Oct 20, 2006
- 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 | DS036908 | PA | Primary |
Addresses
Primary practice location
117 N Main St
Ashley, PA 18706-2323
Mailing address
117 N Main St
Ashley, PA 18706-2323
Phone (570) 824-1009
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000302709 | Other | PA | DENTAL BENEFIT PROVIDERS |
| 1016338340001 | Medicaid | PA | |
| 9183596 | Other | PA | DORAL DENTAL |
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 |
|---|---|---|---|
| DS036908 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585440000000",
"number": "1194807750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 N MAIN ST",
"city": "ASHLEY",
"state": "PA",
"postal_code": "187062323",
"telephone_number": "570-824-1009",
"fax_number": "570-824-1037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 N MAIN ST",
"city": "ASHLEY",
"state": "PA",
"postal_code": "187062323",
"telephone_number": "570-824-1009",
"fax_number": "570-824-1037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "CHOON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2020-03-29",
"certification_date": "2020-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS036908",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BENEFIT PROVIDERS",
"identifier": "000000302709",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1016338340001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL",
"identifier": "9183596",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.