Seunghwan Chung D.D.S., Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SEUNGHWAN CHUNG D.D.S., INC.

Practice address

7291 Boulder Ave Ste 2B
Highland, CA 92346-6900

Phone

(909) 425-8980

NPI assigned

Dec 19, 2022

Organization subpart

No

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

Authorized official

Name

Seunghwan ChungNPI 1629568688

Title

President

Phone

(909) 425-8980

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Seunghwan Chung, DDS

  • Dentist
  • Highland, CA
  • NPI 1629568688
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1669184032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 N VILLA MARIA RD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111657",
            "telephone_number": "909-379-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7291 BOULDER AVE STE 2B",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923466900",
            "telephone_number": "909-425-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEUNGHWAN CHUNG D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "SEUNGHWAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-425-8980"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Segura, OTR/L
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• Kelgynn Sia Serbas, DMD
• Serene Minds Counseling Services
• Edward Refugio Serros, MD
• Dhaval Shah, DDS MDS
• Viral Shah, B.PHARM
• Rosalina Shepard
• Shine Bright Network LLC
• Heather Short

• Dental Clinic/Center in Highland, CA
• Providers in Highland, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.