Individual provider Active NPI

Robyn Eunsun Chong, D.D.S.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1942331673
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53984 Issued in CA
Practice address
130 S Alvarado St
Los Angeles, CA 90057-2238
Phone
(213) 484-9660
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 53984 CA Primary

Addresses

Primary practice location

130 S Alvarado St
Los Angeles, CA 90057-2238

Mailing address

421 S Van Ness Ave Apt 7
Los Angeles, CA 90020-4630

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robyn.chong.p1@direct.eisnerhealth.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220704000306 CA Order and Referring Only - DentistPractitioner - Dentist 3870973142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53984CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: robyn.chong.1@28334.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1942331673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S VAN NESS AVE APT 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572238",
            "telephone_number": "213-484-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "ROBYN",
        "middle_name": "EUNSUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robyn.chong.p1@direct.eisnerhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGenShare, Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1530 S Olive St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900153023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.