Individual provider Active NPI

Catherine K. Chung, D.D.S.

  • General Practice Dentistry
  • Simi Valley, CA
National Provider Identifier
1366458267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41378 Issued in CA
Practice address
1975 Royal Ave Ste 1
Simi Valley, CA 93065-4603
Phone
(805) 526-3636
Fax
(805) 526-7721
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 41378 CA Primary

Addresses

Primary practice location

1975 Royal Ave Ste 1
Simi Valley, CA 93065-4603

Mailing address

1975 Royal Ave Ste 1
Simi Valley, CA 93065-4603
Phone (805) 526-3636

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
41378CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366458267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 ROYAL AVE STE 1",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654603",
            "telephone_number": "805-526-3636",
            "fax_number": "805-526-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 ROYAL AVE STE 1",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654603",
            "telephone_number": "805-526-3636",
            "fax_number": "805-526-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "CATHERINE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.