Active NPI
Kae S.C. Cheng, DMD MD
- Oral and Maxillofacial Surgery (Dentist)
- Eugene, OR
National Provider Identifier
1619025988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- D7930
- Practice address
- 1740 W 17TH Ave
Eugene, OR 97402-3619 - Phone
- (888) 468-0022
- Fax
- (541) 504-3907
- NPI assigned
- Jan 5, 2007
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D7930 | OR | Primary |
Addresses
Primary practice location
1740 W 17TH Ave
Eugene, OR 97402-3619
Mailing address
442 SW Umatilla Ave
Suite 200
Redmond, OR 97756-7039
Phone (888) 480-4478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619025988 | Other | OR | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150707002643 | OR | Order and Referring Only - Oral Surgery | 1951613785 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7930 | OR | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444262400000",
"number": "1619025988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "442 SW UMATILLA AVE",
"address_2": "SUITE 200",
"city": "REDMOND",
"state": "OR",
"postal_code": "977567039",
"telephone_number": "888-480-4478",
"fax_number": "541-504-3907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W 17TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974023619",
"telephone_number": "888-468-0022",
"fax_number": "541-504-3907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENG",
"first_name": "KAE",
"middle_name": "S.C.",
"credential": "DMD MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2015-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "OR",
"license": "D7930",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1619025988",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.