Individual provider Active NPI

Richard Chhu Kun, D.M.D.

  • Dentist
  • Tucson, AZ
National Provider Identifier
1346691268
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9451 Issued in AZ
Practice address
5545 E Broadway Blvd Ste 107
Tucson, AZ 85711-3843
Phone
(520) 399-7356
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9451 AZ Primary

Addresses

Primary practice location

5545 E Broadway Blvd Ste 107
Tucson, AZ 85711-3843

Mailing address

3506 Gloucester Gate St
Las Vegas, NV 89122-3633
Phone (213) 587-3074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160926002358 AZ Order and Referring Only - DentistPractitioner - Dentist 8628365244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Broadway Smiles Dentistry and Orthodontics, LLP General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1346691268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 GLOUCESTER GATE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891223633",
            "telephone_number": "213-587-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 E BROADWAY BLVD STE 107",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113843",
            "telephone_number": "520-399-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUN",
        "first_name": "RICHARD",
        "middle_name": "CHHU",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.