DR. MICHAEL CHUNG D.D.S., M.D.
NPI 1154795656
Oral & Maxillofacial Surgery in San Gabriel, CA
NPI Status: Active since November 20, 2015
Contact Information
360 E LAS TUNAS DR STE 206
SAN GABRIEL, CA
ZIP 91776
Phone: (818) 768-2062
- Individual
- Male
- Oral & Maxillofacial Surgery
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About MICHAEL CHUNG
This page provides the complete NPI Profile along with additional information for Michael Chung, a provider established in San Gabriel, California with a medical specialization in Oral & Maxillofacial Surgery. The healthcare provider is registered in the NPI registry with number 1154795656 assigned on November 2015. The practitioner's primary taxonomy code is 204E00000X with license number 64035 (CA). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1154795656
- Provider Name
- DR. MICHAEL CHUNG D.D.S., M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 360 E LAS TUNAS DR STE 206 SAN GABRIEL, CA 91776
- Location Phone
- (818) 768-2062
- Mailing Address
- 360 E LAS TUNAS DR STE 206 SAN GABRIEL, CA 91776
- Mailing Phone
- (818) 780-2062
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-20-2015
- Last Update Date
- 06-25-2020
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Michael Chung opted out of Medicare effective on 10-07-2025 until 10-07-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Oral & Maxillofacial Surgery
- Taxonomy Code
- 204E00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 64035
- License State
- CA
- Taxonomy Description
- Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 122300000X | Dental Providers | Dentist | 64034 (CA) |
| 2 | 1223S0112X | Dental Providers | Dentist | 64034 (CA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - Basic - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Alabama Preferred Plan - PPO
- Alabama Preferred Plan (Pediatric Only) - PPO
- Alabama Preferred Plus Plan - PPO
- Alabama Preferred Plus Plan (Pediatric Only) - PPO
- Alabama Wellness Essentials Plan - PPO
- Florida Preferred Plan - PPO
- Florida Preferred Plan (Pediatric Only) - PPO
- Florida Preferred Plus Plan - PPO
- Florida Preferred Plus Plan (Pediatric Only) - PPO
- Florida Wellness Essentials Plan - PPO
- High PPO Dental Plan - PPO
- High PPO Dental Plan (Pediatric Only) - PPO
- Kansas Preferred Plan - PPO
- Kansas Preferred Plan (Pediatric Only) - PPO
- Kansas Wellness Essentials Plan - PPO
- Low PPO Dental Plan - PPO
- Low PPO Dental Plan (Pediatric Only) - PPO
- Mississippi Preferred Plan - PPO
- Mississippi Preferred Plan (Pediatric Only) - PPO
- Mississippi Wellness Essentials Plan - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michael Chung is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 10-07-2025
Opt-Out End Date: 10-07-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1154795656, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154795656, enumerated as an "individual" on November 20, 2015.
The provider is located at 360 E LAS TUNAS DR STE 206 SAN GABRIEL, CA 91776 and the phone number is (818) 768-2062.
Oral & Maxillofacial Surgery with taxonomy code 204E00000X.
The provider might be accepting Accepts: Humana and Renaissance Dental. Please consult your insurance carrier or call the provider to verify.
