Active NPI
Earnest Chae
- Dentist
- Lynwood, CA
National Provider Identifier
1982261004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 111091
- Practice address
- 11395 Atlantic Ave
Lynwood, CA 90262-2485 - Phone
- (310) 639-0884
- NPI assigned
- May 23, 2019
- Last updated
- Feb 12, 2025
- Sex
- Male
- Sole proprietor
- No
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 | 111091 | CA | Primary |
Addresses
Primary practice location
11395 Atlantic Ave
Lynwood, CA 90262-2485
Mailing address
19016 Bloomfield Ave
Cerritos, CA 90703-7103
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 |
|---|---|---|---|
| 111091 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739318400000",
"number": "1982261004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19016 BLOOMFIELD AVE",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907037103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11395 ATLANTIC AVE",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902622485",
"telephone_number": "310-639-0884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAE",
"first_name": "EARNEST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-23",
"last_updated": "2025-02-12",
"certification_date": "2025-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "111091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.