Individual provider Active NPI

Charles Choong Hun Chung, DDS

  • Dentist
  • Santa Clarita, CA
National Provider Identifier
1619111465
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46372 Issued in CA
Practice address
27745 Summer Grove PL
Santa Clarita, CA 91354-1895
Phone
(818) 429-6486
NPI assigned
Apr 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 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 46372 CA Primary

Addresses

Primary practice location

27745 Summer Grove PL
Santa Clarita, CA 91354-1895

Mailing address

27745 Summer Grove PL
Santa Clarita, CA 91354-1895
Phone (818) 429-6486

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
I20240201002304 CA Practitioner - Dentist 0446554422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Dec 19, 2023 Accepting new patients
I Zak DDS Prof Dental Corp Dentist Current Accepting new patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Dec 19, 2023 Accepting new patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Dec 19, 2023 Accepting new patients

Locations

10501 Lakewood Blvd
#B
Downey, CA 90241
Phone (562) 862-2341

4167 Ohio St
San Diego, CA 92104
Phone (619) 281-6635

5168 Hollister Ave
Santa Barbara, CA 93111
Phone (805) 683-5300

3355 Cochran St
Ste 206
Simi Valley, CA 93063
Phone (805) 520-1100

41593 Winchester Rd
Ste 211
Temecula, CA 92590
Phone (562) 862-2341

3383 Telegraph Rd
Ventura, CA 93003
Phone (805) 644-9501

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1619111465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27745 SUMMER GROVE PL",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913541895",
            "telephone_number": "818-429-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27745 SUMMER GROVE PL",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913541895",
            "telephone_number": "818-429-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "CHARLES",
        "middle_name": "CHOONG HUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

Verify at the official NPI Registry.