Individual provider Active NPI

Chong Kenneth Ye, D.M.D.

  • Dentist
  • La Habra, CA
National Provider Identifier
1619036472
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54964 Issued in CA
Practice address
651 S Beach Blvd
La Habra, CA 90631-5854
Phone
(562) 691-3697
Fax
(562) 691-3797
NPI assigned
Dec 7, 2006
Last updated
Mar 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54964 CA Primary

Addresses

Primary practice location

651 S Beach Blvd
La Habra, CA 90631-5854

Mailing address

651 S Beach Blvd
La Habra, CA 90631-5854
Phone (562) 691-3697

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160517001790 CA Order and Referring Only - DentistPractitioner - Dentist 4587953427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54964CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chong Kenneth Ye, DMD, Inc. Dentist Past Accepting new patients
Dr Kim Dental Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cye@direct.westerndental.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1619036472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 S BEACH BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906315854",
            "telephone_number": "562-691-3697",
            "fax_number": "562-691-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 S BEACH BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906315854",
            "telephone_number": "562-691-3697",
            "fax_number": "562-691-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YE",
        "first_name": "CHONG",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

Verify at the official NPI Registry.