Chanchai Sangsurasak, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58501 Issued in CA

Practice address

3410 La Sierra Ave Ste D
Riverside, CA 92503-5205

Phone

(951) 354-9550

NPI assigned

Jul 25, 2009

Last updated

Oct 2, 2013By 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 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Chanchai Sangsurasak, DDS Inc.

  dba La Sierra Family Dentistry

  • Dentist
  • Riverside, CA
  • NPI 1164851747
  NPD (past) Authorized official
• La Sierra Family Dentistry

  • Dentist
  • Riverside, CA
  • NPI 1043401664
  NPD (past)

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

{
    "created_epoch": "1248480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1164652053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 LA SIERRA AVE STE D",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035205",
            "telephone_number": "951-354-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 LA SIERRA AVE STE D",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035205",
            "telephone_number": "951-354-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGSURASAK",
        "first_name": "CHANCHAI",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-25",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Henry Rodriguez Sangalang
• Eula Sangalang
• Sumedh Sanghdeep
• Tassaporn Sangkijporn, DO
• Sandeep Chandu Sangodkar, D.O.
• Nicole Ann Sanguino, PT, DPT
• Samer S Sannoufi, MD
• Angelica Santacruz
• Laura Janet Santamaria
• Noel Santamaria, PA

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.