Organization Active NPI

United Dental Group

  • General Practice Dentistry
  • Burlingame, CA
National Provider Identifier
1104033612
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45218 Issued in CA
Legal business name
UNITED DENTAL GROUP
Practice address
1840 El Camino Real
Burlingame, CA 94010-3102
Phone
(650) 777-9195
Fax
(650) 777-9197
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Shih (Michael) W. Tseng, D.D.S.
Title
President
Phone
(650) 777-9195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 45218 CA Primary

Addresses

Primary practice location

1840 El Camino Real
Burlingame, CA 94010-3102

Mailing address

1840 El Camino Real
Burlingame, CA 94010-3102
Phone (650) 777-9195

National Provider Directory

National Provider Directory

Locations

1840 El Camino Real
Burlingame, CA 94010
Phone (650) 697-1500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104033612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 EL CAMINO REAL",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103102",
            "telephone_number": "650-777-9195",
            "fax_number": "650-777-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 EL CAMINO REAL",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103102",
            "telephone_number": "650-777-9195",
            "fax_number": "650-777-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TSENG",
        "authorized_official_first_name": "SHIH   (MICHAEL)",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-777-9195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.