Grace Yoon Mi Chung, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56252 Issued in CA

Practice address

27110 Eucalyptus Ave
Suite a
Moreno Valley, CA 92555-4542

Phone

(951) 616-1759

NPI assigned

Nov 26, 2007

Last updated

Jun 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Yoon Mi Chung Former name

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

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.

• Cheung and Nosti Dental Corporation

  dba Stoneridge Dental Group

  • General Practice Dentistry
  • Moreno Valley, CA
  • NPI 1982884094
  NPD (past)

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338681600000",
    "number": "1649451196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27110 EUCALYPTUS AVE",
            "address_2": "SUITE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554542",
            "telephone_number": "951-616-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27110 EUCALYPTUS AVE",
            "address_2": "SUITE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554542",
            "telephone_number": "951-616-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "GRACE",
        "middle_name": "YOON MI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2012-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YOON",
            "last_name": "CHUNG",
            "middle_name": "MI",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tony W. Chu, D.C.
• Samnuel Choa Chua, M.D.
• Leslie Chun
• Alastair Xavier Chung, DPT
• Chang Cho Chung, D.C
• Tina Baotin Tan Chuong, PHARM. D
• Nelly Karina Chuqui Medina, MD
• Shauna Churchill
• Geyli Cifuentes
• Lysa Cimicato, DPT

• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, 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 Jun 3, 2012; 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.