Individual provider Active NPI

Rajkumar Jaisingh, DDS

  • General Practice Dentistry
  • Cerritos, CA
National Provider Identifier
1053047498
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108060 Issued in CA
Practice address
11549 South St
Cerritos, CA 90703-6627
Phone
(562) 278-1609
NPI assigned
Jul 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 108060 CA Primary

Addresses

Primary practice location

11549 South St
Cerritos, CA 90703-6627

Mailing address

7411 Edinger Ave Unit 313
Huntington Beach, CA 92647-7837
Phone (408) 887-6350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119001670 CA Order and Referring Only - DentistPractitioner - Dentist 4284005745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108060CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Wong Dental Corporation General Practice CurrentSince Jul 31, 2022 Accepting new patients

Locations

11549 South St
Cerritos, CA 90703
Phone (562) 278-1609

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1053047498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 EDINGER AVE UNIT 313",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477837",
            "telephone_number": "408-887-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11549 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036627",
            "telephone_number": "562-278-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAISINGH",
        "first_name": "RAJKUMAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-11-09",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.