Yu-CHI Ricky Chung, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

55244 Issued in CA

Practice address

17122 Slover Ave Ste 103
Fontana, CA 92337-7588

Phone

(909) 829-3994

NPI assigned

Mar 20, 2007

Last updated

Dec 5, 2017By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1548385685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17122 SLOVER AVE STE 103",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377588",
            "telephone_number": "909-829-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17122 SLOVER AVE STE 103",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377588",
            "telephone_number": "909-829-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "YU-CHI",
        "middle_name": "RICKY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5181",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548385685",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Success Chukwu
• Jenny Y Chung, PHARMD
• Juna Y Chung, LCSW
• Siu-Keung Chung, M.D.
• Wynda Wen Ta Chung, MD
• Andy Chuu, MD
• Giuliana Cilliani, PA-C
• Ha Sarreong Cillpame, DPT
• Iresha Linda Cioco, PMHNP
• Citrus Nursing Center

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.