Individual provider Active NPI

Chunkil Yi

  • Dentist
  • El Paso, TX
National Provider Identifier
1982924171
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
25483 Issued in TX
Practice address
9584 Dyer St Ste B
El Paso, TX 79924-4748
Phone
(915) 751-1007
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25483 TX Primary

Addresses

Primary practice location

9584 Dyer St Ste B
El Paso, TX 79924-4748

Mailing address

9584 Dyer St Ste B
El Paso, TX 79924-4748
Phone (915) 751-1007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160526001206 TX Order and Referring Only - DentistPractitioner - Dentist 6002106457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Viva Dental Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1982924171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9584 DYER ST STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244748",
            "telephone_number": "915-751-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9584 DYER ST STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244748",
            "telephone_number": "915-751-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "CHUNKIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.