Sreynoch Hun, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019035073 Issued in IL

Practice address

13510 Julie Dr
Poplar Grove, IL 61065-7829

Phone

(815) 765-4003

NPI assigned

Apr 5, 2024

Last updated

Aug 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Srey Noch Lach Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

State licenses

Practice roles

Locations

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.

• Friend Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1578560090
  Medicare reassignment NPD
• Friend Family Health Center Inc

  dba Friend Health - Gresham

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1477175305
  NPD

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1700638335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 S HIGHLAND AVE APT 4J",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485347",
            "telephone_number": "323-283-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13510 JULIE DR",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "610657829",
            "telephone_number": "815-765-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUN",
        "first_name": "SREYNOCH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019035073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SREY",
            "last_name": "LACH",
            "middle_name": "NOCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gemma Fletcher
• Jennifer Gallagher, PTA
• Laura Grant, PHD, CF-SLP
• Hoffman Chiropractic and Wellness Clinic
• Christopher Hoffman, D.C.
• Lauren Licausi, M.S., CCC-SLP/L
• Linda Lowry, RN
• Kelly Zane Maffei, M.S.
• Tracy Lynn Marcus, RBT
• Ashley Lynn Moritz, M.S., CCC-SLP/L

• General Practice Dentistry in Poplar Grove, IL
• Providers in Poplar Grove, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.