Nicole Chung, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

63418 Issued in CA

Practice address

143 S Mason St
Arroyo Grande, CA 93420-3312

Phone

(909) 913-3429

NPI assigned

Oct 10, 2012

Last updated

Nov 21, 2022By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Nicole Chung DMD Endodontic Dental Practice

  dba Five Cities Endodontics

  • Dental Clinic/Center
  • Arroyo Grande, CA
  • NPI 1902528672
  NPD Authorized official

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1811249139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 TARRAGON LN",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017264",
            "telephone_number": "909-913-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S MASON ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203312",
            "telephone_number": "909-913-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "NICOLE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "63418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Siu Ping Chan, M.D.
• G Chan, PHARMD
• Janel A Chavez, LCSW
• Sherry Leigh Christensen, PHARMACY TECHNICIAN
• Timothy Levi Christopher, PT, DPT
• Janet Clark, PSY, LEP, BCBA
• Anthony Thomas Clementi
• Coast Nursing Anesthesia, Inc
• Coast Radiology Medical Associates a California General Partnership
• Coastal Cardiology a Medical Corp

• Endodontics in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.