Active NPI
Ki Y Chung, D.D.S.
- Dentist
- Ft Belvoir, VA
National Provider Identifier
1871928150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-4528
- Practice address
- 9910 Tracy Loop
W3ZS USA Dentac Ft Belvoi
Ft Belvoir, VA 22060-5443 - Phone
- (562) 455-5574
- NPI assigned
- Sep 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-4528 | ID | Primary |
Addresses
Primary practice location
9910 Tracy Loop
W3ZS USA Dentac Ft Belvoi
Ft Belvoir, VA 22060-5443
Mailing address
9910 Tracy Loop
W3ZS USA Dentac Ft Belvoi
Ft Belvoir, VA 22060-5443
Phone (562) 455-5574
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
| License | State | Type | Specialty |
|---|---|---|---|
| D-4528 | ID | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1871928150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9910 TRACY LOOP",
"address_2": "W3ZS USA DENTAC FT BELVOI",
"city": "FT BELVOIR",
"state": "VA",
"postal_code": "220605443",
"telephone_number": "562-455-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9910 TRACY LOOP",
"address_2": "W3ZS USA DENTAC FT BELVOI",
"city": "FT BELVOIR",
"state": "VA",
"postal_code": "220605443",
"telephone_number": "562-455-5574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "KI",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-05",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-4528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.