MR. TAE SUB CHUNG (NPI# 1497967566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497967566 |
| Entity Type | Individual |
| Full Name | MR. TAE SUB CHUNG |
| Credential | DDS |
| Practice Address |
15622 S Crenshaw Blvd Ste B Gardena CA 90249-4528 |
| Practice Telephone | 3103239922 |
| Practice Fax Number | 3105153551 |
| Mailing Telephone | 3103239922 |
| Mailing Fax Number | 3105153551 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 26363 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTICAL | B2636301 | 01 |
| Street Address |
15622 S CRENSHAW BLVD STE B |
| City | GARDENA |
| State | CA |
| Zip Code | 90249-4528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821518085 | Jin Taek Limb | Chiropractor | 2911 W 135th Pl, Gardena, CA 90249 | 2017-06-20 |
| 1083084651 | Charde Antoinette | Home Health | 2923 W 138th, Gardena, CA 90249 | 2015-09-25 |
| 1316330145 | Lupita Martinez | Marriage & Family Therapist | 15120 Atkinson Ave Ste 7, Gardena, CA 90249 | 2015-03-18 |
| 1699100487 | Asian American Drug Abuse Program, Inc | Community/Behavioral Health | 14112 S. Kingsley Dr., Gardena, CA 90249 | 2013-09-11 |
| 1992142327 | Vin'ash Coaching, LLC | Private Vehicle | 3163 W 154th Place, Gardena, CA 90249 | 2013-05-24 |
| 1811287048 | Best-option Home Health Agency Inc. | Home Health | 15223 S Crenshaw Blvd Suite A, Gardena, CA 90249 | 2011-04-08 |
| 1356644439 | Ameripride Ambulance Service, Inc. | Ambulance | 13509 South Raymond Avenue, Gardena, CA 90249 | 2010-12-13 |
| 1164732327 | Ctc Healthcare Services Inc | In Home Supportive Care | 13108 Arcturus Avenue, Gardena, CA 90249 | 2010-10-20 |
| 1407170996 | Marl Soon Chung | Dentist | 15622 S. Crenshaw Blvd #b, Gardena, CA 90249 | 2010-03-26 |
| 1164677464 | Grace Jiyoung Park | Family Medicine | 15446 S. Western Ave, Southern California Permanente Medical Group, Gardena, CA 90249 | 2008-12-01 |
| Find all providers in zip 90249 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736513 | O.h. Barkhordar D.d.s.,inc. | Dentist | 1600 W Redondo Beach Blvd Ste 203, Gardena, CA 90247-3228 | 2020-10-08 |
| 1225645252 | Normandy Bay Joseph Dental Group | Dentist | 14011 Van Ness Ave, Gardena, CA 90249-2915 | 2020-09-24 |
| 1508426677 | Western Dental Services, Inc. | Dentist | 15515 Normandie Ave, Gardena, CA 90247-4013 | 2019-06-19 |
| 1255873345 | Shiwoo Kim | Dentist | 1502 W Artesia Sq Apt B, Gardena, CA 90248-4761 | 2016-11-07 |
| 1730531666 | Christopher Yoo | Dentist | 1661 W 158th St # 204, Gardena, CA 90247-3890 | 2016-07-03 |
| 1407170996 | Marl Soon Chung | Dentist | 15622 S. Crenshaw Blvd #b, Gardena, CA 90249 | 2010-03-26 |
| 1649465121 | Syg Dental Corporation | Dentist | 1210 W Redondo Beach Blvd, Gardena, CA 90247-3411 | 2007-09-08 |
| 1104028505 | Mark Anthony Gerger | Dentist | 2235 W Rosecrans Ave, Gardena, CA 90249-2905 | 2007-06-05 |
| 1720298094 | Amir Saz | Dentist | 1104 W Redondo Beach Blvd, Gardena, CA 90247-3512 | 2007-05-23 |
| 1982828562 | Yukinobu Tom Tomoda | Dentist | 15474 S Western Ave, Gardena, CA 90249-4325 | 2007-04-13 |
| Find all providers in GARDENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.