Active NPI
Myungso Chung
- Dentist
- Schofield Barracks, HI
National Provider Identifier
1235500307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 35849
- Practice address
- 315 Brannon Rd
Schofield Barracks, HI 96857 - Phone
- (808) 433-8843
- NPI assigned
- Oct 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 35849 | TX | Primary |
Addresses
Primary practice location
315 Brannon Rd
Schofield Barracks, HI 96857
Mailing address
11230 Thorn Apple
San Antonio, TX 78253-6257
Phone (210) 517-9314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151109002371 | NJ | Order and Referring Only - Dentist | 6608186390 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35849 | TX | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1235500307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11230 THORN APPLE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782536257",
"telephone_number": "210-517-9314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 BRANNON RD",
"city": "SCHOFIELD BARRACKS",
"state": "HI",
"postal_code": "96857",
"telephone_number": "808-433-8843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "MYUNGSO",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-14",
"last_updated": "2024-07-16",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "35849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schofield Barracks, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.