| Doctor Name: | DR. CHONG PEI NIKKI PUNG-YAMATO |
| NPI Number: | 1255625554 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DDS |
| License Number: | 055558-1 |
| Business Practice Address: | 6399 Christie Ave #338 Emeryville, CA - 946081382 |
| Business Phone Number: | 5102605151 |
| Business Fax Number: | |
| Mailing Address: | 6399 Christie Ave, #338 EMERYVILLE |
| State: | CA |
| Postal Code: | 946081382 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2011 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 055558-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |