Carlos Roberto Chong, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42640 Issued in CA

Practice address

169 Saxony Rd Ste 110
Encinitas, CA 92024-6779

Phone

(760) 634-7980

Fax

(760) 634-7982

NPI assigned

Jul 19, 2006

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carlos R Chong a Professional Dental Corporation

  • Dental Clinic/Center
  • Encinitas, CA
  • NPI 1154525590
  NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1538188263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 SAXONY RD STE 110",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920246779",
            "telephone_number": "760-634-7980",
            "fax_number": "760-634-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 SAXONY RD STE 110",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920246779",
            "telephone_number": "760-634-7980",
            "fax_number": "760-634-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "CARLOS",
        "middle_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Wanida Chinothai, BA
• Jane Elizabeth Chippendale
• Chirosolutions
• Chong Acupuncture and Integrative Medicine
• Chong Medicine Inc (Chong Acupuncture and Integrative Medicine)
• Siatnee Chong, L.AC
• Timothy Chow, PHARMD
• Punam Chowdhury, MD
• Alicia Christiansen, MD
• Christopher J Miller Chiropractic Inc

• General Practice Dentistry in Encinitas, CA
• Providers in Encinitas, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.