Individual provider Active NPI

Joe Cheng, DDS

  • General Practice Dentistry
  • Simi Valley, CA
National Provider Identifier
1124171145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38818 Issued in CA
Practice address
2045 Royal Ave Ste 230
Simi Valley, CA 93065-4600
Phone
(805) 526-3300
Fax
(805) 526-3113
NPI assigned
Jan 21, 2007
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 38818 CA Primary

Addresses

Primary practice location

2045 Royal Ave Ste 230
Simi Valley, CA 93065-4600

Mailing address

2045 Royal Ave Ste 230
Simi Valley, CA 93065-4600
Phone (805) 526-3300

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
I20160121001556 CA Order and Referring Only - DentistPractitioner - Dentist 4981907169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124171145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE STE 230",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654600",
            "telephone_number": "805-526-3300",
            "fax_number": "805-526-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE STE 230",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654600",
            "telephone_number": "805-526-3300",
            "fax_number": "805-526-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.