Euiyoung Chong, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100189815 Issued in WI

Practice address

17160 W North Ave Ste 101
Brookfield, WI 53005-4437

Phone

(626) 833-7445

NPI assigned

Jul 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Quirt Family Dentistry, SC

  • General Practice Dentistry
  • Bellevue, WI
  • NPI 1225447436

  General Practice

  NPD (past)

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1831677244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17160 W NORTH AVE STE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054437",
            "telephone_number": "626-833-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17160 W NORTH AVE STE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054437",
            "telephone_number": "626-833-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2014 Lime Kiln Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WI",
            "postal_code": "543116206",
            "country_code": "US",
            "telephone_number": "920-857-2092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHONG",
        "first_name": "EUIYOUNG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4345",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "100189815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiro One Wellness Center of Brookfield LLC
• Chiropractic Company - 23 LTD
• Chiropractic Company - Brookfield LTD
• Chiropractic Company S.C.
• Jennifer Chmielewski
• Chosen One Adult Family LLC
• Christian Counseling Associates LLC
• Christian Life Counseling LLC
• Christian Life Counseling LLC
• Christiansen Chiropractic, S.C.

• All providers in Brookfield, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.