Individual provider Active NPI

Fenghua Fu, DDS

  • General Practice Dentistry
  • La Puente, CA
National Provider Identifier
1093845398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53212 Issued in CA
Practice address
13704 Amar Rd
La Puente, CA 91746-1601
Phone
(626) 917-3088
NPI assigned
Mar 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 53212 CA Primary

Addresses

Primary practice location

13704 Amar Rd
La Puente, CA 91746-1601

Mailing address

13704 E. Amar Road
La Puente, CA 91746-1601
Phone (626) 917-3088

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
I20190503002347 CA Practitioner - Oral SurgeryPractitioner - Dentist 0941521371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fenghua Fu D.D.S., a Professional Corporation General Practice CurrentSince May 1, 2018 Accepting new patients
Vahid Einolllahi General Practice Past Accepting new patients

Locations

13732 Euclid St
Garden Grove, CA 92843
Phone (714) 530-0921

13704 Amar Rd
La Puente, CA 91746
Phone (626) 917-3088

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093845398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13704 E. AMAR ROAD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461601",
            "telephone_number": "626-917-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13704 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461601",
            "telephone_number": "626-917-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "FENGHUA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

Verify at the official NPI Registry.