Individual provider Active NPI

Kristy Chung, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sunnyvale, CA
National Provider Identifier
1285667972
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
51563 Issued in CA
Practice address
860 E. Remington Dr. Suite a
Sunnyvale, CA 94087
Phone
(408) 675-1700
Fax
(408) 542-9797
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 20693 MA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 51563 CA Primary

Addresses

Primary practice location

860 E. Remington Dr. Suite a
Sunnyvale, CA 94087

Mailing address

860 E. Remington Dr. Suite a
Sunnyvale, CA 94087
Phone (408) 675-1700

Other identifiers 1

IdentifierTypeStateIssuer
0204358MedicaidMA

Other names 1

  • Kyung Won Chung Former name

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

LicenseStateTypeSpecialty
20693MAMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: kchung249468@direct-ucsfmedicalcenter.org

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1285667972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E. REMINGTON DR. SUITE A",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "94087",
            "telephone_number": "408-675-1700",
            "fax_number": "408-542-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 E. REMINGTON DR. SUITE A",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "94087",
            "telephone_number": "408-675-1700",
            "fax_number": "408-542-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "KRISTY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "20693",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204358",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYUNG",
            "last_name": "CHUNG",
            "middle_name": "WON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.