IndividualActive
Tae Sub Chung, DDS
NPI 1497967566 · Dentist · Gardena, CA
Tae Sub Chung, DDS is a Dentist provider in Gardena, CA (NPI 1497967566).
Provider details
- NPI number
- 1497967566
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 26363 (CA)
Practice location
15622 S Crenshaw Blvd
Ste B
Gardena, CA 90249-4528
Phone: (310) 323-9922
Fax: (310) 515-3551
Street-level locationGet directions
Mailing address
15622 S Crenshaw Blvd
Gardena, CA 90249-4528
Registry dates
- Enumerated
- 2007-05-03
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.