Active NPI
Nicholas Chung, DMD
- Endodontics
- Winter Park, FL
National Provider Identifier
1396364006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN24929
- Practice address
- 400 W Morse Blvd Ste 102
Winter Park, FL 32789-4259 - Phone
- (407) 644-4463
- NPI assigned
- Apr 13, 2020
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN24929 | FL | Primary |
Addresses
Primary practice location
400 W Morse Blvd Ste 102
Winter Park, FL 32789-4259
Mailing address
1305 Morgan Stanley Ave Unit 516
Winter Park, FL 32789-1977
Phone (407) 865-2080
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 |
|---|---|---|---|
| DN24929 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1396364006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 MORGAN STANLEY AVE UNIT 516",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327891977",
"telephone_number": "407-865-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W MORSE BLVD STE 102",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327894259",
"telephone_number": "407-644-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-13",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN24929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.