Justin Tony Chung DDS, Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

56138 Issued in CA

Legal business name

JUSTIN TONY CHUNG DDS, INC

Doing business as

Eva dental center

Practice address

9550 Bolsa Ave Ste 218
Westminster, CA 92683-5948

Phone

(714) 775-3699

Fax

(714) 775-3899

NPI assigned

Nov 6, 2010

Last updated

Nov 6, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Tony Chung, DDS

Title

Ceo

Phone

(714) 775-3699

Specialties & licenses 1

Addresses

Other names 1

• Eva dental center Doing business as

Locations

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

{
    "created_epoch": "1289001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289001600000",
    "number": "1811298813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 BOLSA AVE STE 218",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835948",
            "telephone_number": "714-775-3699",
            "fax_number": "714-775-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 BOLSA AVE STE 218",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835948",
            "telephone_number": "714-775-3699",
            "fax_number": "714-775-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN TONY CHUNG DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-06",
        "last_updated": "2010-11-06",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-775-3699",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "56138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eva dental center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Preferred Provider Organization in Westminster, CA
• Providers in Westminster, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2010; 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.