Active NPI
Mia Chun, D.D.S.
- Dentist
- Hayward, CA
National Provider Identifier
1285786053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 38823
- Practice address
- 24301 Southland Dr Ste 505
Hayward, CA 94545-1553 - Phone
- (510) 785-3900
- Fax
- (510) 785-6141
- NPI assigned
- Jan 18, 2007
- 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 | 38823 | CA | Primary |
Addresses
Primary practice location
24301 Southland Dr Ste 505
Hayward, CA 94545-1553
Mailing address
24307 Southland Dr
Hayward, CA 94545-1517
Phone (510) 785-3900
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 |
|---|---|---|---|
| 38823 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chung Dental Group Inc. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Hayward, CA
- NPI 1376002634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1285786053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24307 SOUTHLAND DR",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945451517",
"telephone_number": "510-785-3900",
"fax_number": "510-785-6141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24301 SOUTHLAND DR STE 505",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945451553",
"telephone_number": "510-785-3900",
"fax_number": "510-785-6141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUN",
"first_name": "MIA",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "38823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.