Pang Ko, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

64986 Issued in CA

Practice address

30 Nightingale Ave Building 5513
Edwards, CA 93524-0001

Phone

(661) 277-2872

NPI assigned

Mar 9, 2015

Last updated

Feb 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1144613670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NIGHTINGALE AVE BUILDING 5513",
            "city": "EDWARDS",
            "state": "CA",
            "postal_code": "935240001",
            "telephone_number": "661-277-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NIGHTINGALE AVE BUILDING 5513",
            "city": "EDWARDS",
            "state": "CA",
            "postal_code": "935240001",
            "telephone_number": "661-277-2872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1549 W 7th St",
            "address_2": "#104",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917866954",
            "country_code": "US",
            "telephone_number": "559-300-7596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KO",
        "first_name": "PANG",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64986",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Ngan Thi Dunlap, LCSW
• Wesley John Fischer, R.PH
• Adrian Vidal Flores Lopez, PPS
• Dyann Hanes
• Shelina Hardwick-Moses, LPN
• Phillip Lopiccolo, D.D.S.
• Franklin Miranda, IDMT
• Cheyenne E Monroe-Backus, LCSW
• David George Morrison Jr., PA-C
• Tracy Adell Neal-Walden, PH.D.

• Dentist in Edwards, CA
• Providers in Edwards, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.