Individual provider Active NPI

Christopher Tung, DMD

  • Dentist
  • Redmond, WA
National Provider Identifier
1306277934
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63125 Issued in CA
Practice address
16510 Cleveland St
Suite Q
Redmond, WA 98052-4439
Phone
(425) 882-1112
NPI assigned
Dec 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63125 CA Primary
Dentist 122300000X DE60417176 WA

Addresses

Primary practice location

16510 Cleveland St
Suite Q
Redmond, WA 98052-4439

Mailing address

4090 N Chestnut Ave
Apt 201
Fresno, CA 93726-4707
Phone (206) 856-1411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20160808000797 WA Order and Referring Only - DentistPractitioner - Dentist 3274827621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60417176WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Mu DMD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ctung@direct.westerndental.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1386460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1306277934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 N CHESTNUT AVE",
            "address_2": "APT 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264707",
            "telephone_number": "206-856-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16510 CLEVELAND ST",
            "address_2": "SUITE Q",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524439",
            "telephone_number": "425-882-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "CHRISTOPHER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-08",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63125",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60417176",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.