Chong Pei Nikki Pung-Yamato, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

60977 Issued in CA

Practice address

6399 Christie Ave
#338
Emeryville, CA 94608-1382

Phone

(510) 260-5151

NPI assigned

Jun 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1255625554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6399 CHRISTIE AVE",
            "address_2": "#338",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6399 CHRISTIE AVE",
            "address_2": "#338",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081382",
            "telephone_number": "510-260-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNG-YAMATO",
        "first_name": "CHONG PEI",
        "middle_name": "NIKKI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055558-1",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "60977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Elizabeth Price, NP
• Goodwill C Princewill
• Elizabeth Marie Pulido, DPM
• Ivy Pulse
• Pulze Residential Care Group, LLC
• Rhealynne Quindor, FNP-BC
• Diana Quintero Salazar
• Lorien Elizabeth Quirk, BCBA
• Radnet Management I, Inc.
• Robert Rafal

• Pediatric Dentistry in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.

Verify at the official NPI Registry.