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DR. JACK KOJI CHUNG DDS
NPI 1780665638
Dentist - General Practice in Travis Afb, CA

Active since November 08, 2005PECOS Enrolled
60 MDG/SGDD, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535(707) 423-7000 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 12, 2025, Jul 11, 2025, Oct 25, 2022 and 3 more (6 updates tracked since 2019).

About Dr. Jack Koji Chung Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK KOJI CHUNG DDS (NPI 1780665638) is an individual general practice provider in Travis Afb, California, licensed in Illinois (019026052) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780665638
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JACK KOJI CHUNGCredential: DDS
Location Address60 MDG/SGDD, 101 BODIN CIRCLETravis Afb, CA 94535-1800
Mailing Address60 Mdg/sgdd, 101 Bodin CircleTravis Afb, CA 94535-1800 · (707) 423-7000
Phone(707) 423-7000
Sole ProprietorNo
Enumeration DateNovember 8, 2005
Last NPPES UpdateAugust 12, 20256 updates tracked since enumeration
NPPES CertifiedAugust 7, 2025
✔ NPI 1780665638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 019026052
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
60 MDG/SGDD, Travis Afb, CA 94535
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Koji Chung Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94535 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.85 typical visit price
range $65.02 – $191.95
Typical copayment $24.71 (range $16.25 – $47.98)
Most-billed visit code 99203
Established Patient
$80.24 typical visit price
range $21.86 – $157.69
Typical copayment $20.06 (range $5.46 – $39.42)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TERESA ELLEN REEVES DDS
Dentist (Oral and Maxillofacial Radiology)
60 MDG/SGDD, 101 BODIN CIRCLE, TRAVIS AFB
TRAVIS AFB, CA 94535
Solano County (707) 423-7008
PAULENCIA LAJOI MORRIS D.D.S
Dentist (Pediatric Dentistry)
60 MDG/SGDD, 101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-7000
AUSTIN DOUGLAS WOOD DDS
Dentist (General Practice)
60 MDG/SGDD, 101 BODIN CIRCLE
TRAVIS AFB, CA 94535
Solano County (707) 423-7000
DR. SON XUAN VU DDS
Dentist (General Practice)
60 MDG/SGDD, 101 BODIN CIRCLE
TRAVIS AFB, CA 94535
Solano County (707) 423-7000
DR. EMILLIE CLAIRE BRANDT DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
60 MDG/SGDD, 101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-7000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Chung's NPI number?

The NPI number for Jack Chung is 1780665638. It was assigned to this individual provider in the NPPES registry on November 8, 2005.

Where is Jack Chung located?

Jack Chung practices at 60 Mdg/Sgdd 101 Bodin Circle, Travis Afb, CA 94535. The listed phone number is (707) 423-7000.

What is Jack Chung's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jack Chung enrolled in Medicare?

Yes. Jack Chung is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Chung was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.