Healthcare Provider Details

I. General information

NPI: 1730211772
Provider Name (Legal Business Name): CHRISTOPHER PYUNGBAE CHAE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PYUNGBAE CHAE D.D.S.

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9837 FOLSOM BLVD J
SACRAMENTO CA
95827-1356
US

IV. Provider business mailing address

9837 FOLSOM BLVD STE J
SACRAMENTO CA
95827-1356
US

V. Phone/Fax

Practice location:
  • Phone: 916-364-7111
  • Fax: 916-364-1040
Mailing address:
  • Phone: 916-364-7111
  • Fax: 916-364-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number46248
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number46248
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: