So Hyun Chung

Primary specialty

DentistTaxonomy code 122300000X

License

105023 Issued in CA

Practice address

18876 Van Buren Blvd
#107
Riverside, CA 92508

Phone

(951) 789-0200

NPI assigned

Jul 22, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Sopheap Tang DMD Dental Corporation

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1255610242
  NPD

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1770191041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10996 RINCON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923545219",
            "telephone_number": "909-801-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18876 VAN BUREN BLVD",
            "address_2": "#107",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92508",
            "telephone_number": "951-789-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10996 Rincon St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923545219",
            "country_code": "US",
            "telephone_number": "909-801-4492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SO HYUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice Chung
• Joseph Chung
• Josiah Ian Chung
• Mindy H Chung
• Raymond Dougwon Chung, LMFT
• Vivian Shalom Chung
• Yukuen Chung, M.D.
• Nyemal Chuol
• Emily Chupek
• Chuquimia'S Enterprises Incorporated

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.