JAE CHUNG
NPI 1902579949
Dentist in San Bernardino, CA

Q: What is Jae Chung's NPI number?

The NPI number for Jae Chung is 1902579949. It was assigned to this individual provider in the NPPES registry on July 27, 2021.

Q: What is Jae Chung's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Jae Chung was last updated on July 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since July 27, 2021

654 W 4TH ST # A, SAN BERNARDINO, CA 92410(909) 386-3650 Get Directions Write a Review

NPPES record last updated: July 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jae Chung NPPES

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

JAE CHUNG (NPI 1902579949) is an individual dentist in San Bernardino, California, licensed in California (DDS105162) and active in the NPI registry since July 2021.

NPPES Registry Identity

NPI1902579949

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameJAE CHUNG

Location Address654 W 4TH ST # ASan Bernardino, CA 92410-3216

Mailing AddressPo Box 213Loma Linda, CA 92354-0213

Phone(909) 386-3650

Sole ProprietorYes

Enumeration DateJuly 27, 2021

NPPES CertifiedJuly 27, 2021

✔ NPI 1902579949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · DDS105162

Definition

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.

654 W 4TH ST # A, San Bernardino, CA 92410

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Other Providers at the Same Location NPPES

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

LEE MIYAUCHI DDS

Dentist (Pediatric Dentistry)

654 W 4TH ST # A
SAN BERNARDINO, CA 92410

San Bernardino County (909) 693-4103

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 Jae Chung's NPI number?

The NPI number for Jae Chung is 1902579949. It was assigned to this individual provider in the NPPES registry on July 27, 2021.

Where is Jae Chung located?

Jae Chung practices at 654 W 4th St # A, San Bernardino, CA 92410. The listed phone number is (909) 386-3650.

What is Jae Chung's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Jae Chung was last updated on July 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.