Individual provider Active NPI

Ji-Yeon Chung, D.D.S.

  • Endodontics
  • Flushing, NY
National Provider Identifier
1760442701
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
049188 Issued in NY
Practice address
133-08 41Ave
First FL.
Flushing, NY 11355-3629
Phone
(718) 762-7888
Fax
(718) 762-7588
NPI assigned
Mar 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 049188 NY Primary

Addresses

Primary practice location

133-08 41Ave
First FL.
Flushing, NY 11355-3629

Mailing address

133-08 41Ave First FL.
Flushing, NY 11355-3629
Phone (718) 762-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
049188NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760442701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133-08 41AVE FIRST FL.",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553629",
            "telephone_number": "718-762-7888",
            "fax_number": "718-762-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133-08 41AVE",
            "address_2": "FIRST FL.",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553629",
            "telephone_number": "718-762-7888",
            "fax_number": "718-762-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JI-YEON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "049188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.