Jeannie Chung, DDS, Ms, Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

37538 Issued in CA

Legal business name

JEANNIE CHUNG, DDS, MS, INC

Practice address

39055 Hastings St
Suite 104
Fremont, CA 94538-1518

Phone

(510) 794-9954

Fax

(510) 794-1796

NPI assigned

Jan 20, 2007

Last updated

Dec 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeannie Chung, DDSNPI 1265701528

Title

President

Phone

(510) 794-9954

Specialties & licenses 2

Addresses

Other names 1

• Ronald K. Fujitaki, DDS, MS Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeannie Chung, DDS

  • Periodontics
  • Fremont, CA
  • NPI 1265701528
  NPD (past) Authorized official

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1457404592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39055 HASTINGS ST",
            "address_2": "SUITE 104",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39055 HASTINGS ST",
            "address_2": "SUITE 104",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381518",
            "telephone_number": "510-794-9954",
            "fax_number": "510-794-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNIE CHUNG, DDS, MS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-794-9954",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "38284",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "37538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ronald K. Fujitaki, DDS, MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sruthi Jayakumar, DDS
• Mayuri Jayaraman
• Shilpa Jayaramaswamy Sulochana, MD
• Juliette Dominique Jayme, APCC, PPSC
• Rebekah Jazdzewski
• Jeffrey Scott Stuart, M.D., Inc.
• Jeffrey Wang, DDS
• Keith A Jeffrey, PA-C
• Hanlon B. Jen, MD
• Connie Jenkins

• Periodontics in Fremont, CA
• Providers in Fremont, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.