Tyler Chung, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

110838 Issued in CA

Practice address

1115 S Sanderson Ave
Hemet, CA 92545-9047

Phone

(951) 404-5307

NPI assigned

Jul 3, 2023

Last updated

Sep 25, 2024By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hart and Lee Dental Corporation

  dba Hemet Modern Dentistry Dental Group

  • Dentist
  • Hemet, CA
  • NPI 1699264473
  NPD (past)

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1881371789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 E SUNSET DR N",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737649",
            "telephone_number": "909-633-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SANDERSON AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925459047",
            "telephone_number": "951-404-5307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-998-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "TYLER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Chrisman, O.D.
• Nelly Patricia Christian
• Summer Nicole Christian
• Christina Hsin-Chieh Lin, DDS, a Professional Corporation
• Mykesha Femi Chubbs, MASTERS DEGREE
• Tina Raquel Cifuentes, MD
• Mariana Ciobanu, MD
• Citadel Residential Treatment Facility
• Citrus Gardens Leasing LLC (Citrus Gardens Memory Care)
• City of the Heart Psychological Service, a Professional Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.