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Peter J Chung

Dentist

Dental Providers

PECOS Enrollment

This provider is enrolled in PECOS as PETER CHUNG.

Based on the most recent information from CMS, provider Peter J Chung is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1831504166
Provider Type
Individual
Full Name
Chung, Peter J
Credential
D.M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/25/2014
Last Updated
7/21/2022

Contact Information

Practice Location

1441 Liberty St, Redding, CA 96001-0811

(530) 226-1750

Unlisted Fax

Mailing Location

870 Mission Sierra Ct Apt 10, Redding, CA 96003-3870

(407) 375-9035

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 100115 California

Peter J Chung

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

King, Kenneth J

Colas, Marisa Yau

Flores Lavenant, Carlos

Vodak, Thomas Arthur

Ahmad, Zain

Golles, Dee Eugene

Zufall, Andrew Blake

Huang, Daniel R

Ann Malotky, Dds., Inc.

Pierce, Franklin