Active NPI
Jae Yon Chung, D.M.D
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1346306396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 54473
- Practice address
- 1570 S Western Ave
#201
Los Angeles, CA 90006-5829 - Phone
- (323) 733-4567
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 54473 | CA | Primary |
Addresses
Primary practice location
1570 S Western Ave
#201
Los Angeles, CA 90006-5829
Mailing address
386 S. Burnside Ave
#4-H
Los Angeles, CA 92844-1451
Phone (310) 346-2148
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jae Yon Chung DMD Dental Corporation | 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
- Los Angeles, CA
- NPI 1245490671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224460800000",
"number": "1346306396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "386 S. BURNSIDE AVE",
"address_2": "#4-H",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "928441451",
"telephone_number": "310-346-2148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1570 S WESTERN AVE",
"address_2": "#201",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900065829",
"telephone_number": "323-733-4567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "JAE",
"middle_name": "YON",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2008-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "54473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.