NPIMap

Organization Active NPI

Chanchai Sangsurasak, DDS Inc.

Doing business as La Sierra Family Dentistry

  • Dentist
  • Riverside, CA
National Provider Identifier
1164851747
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58501 Issued in CA
Legal business name
CHANCHAI SANGSURASAK, DDS INC.
Doing business as
La Sierra Family Dentistry
Practice address
3410 La Sierra Ave
Suite D
Riverside, CA 92503-5270
Phone
(951) 354-9550
Fax
(951) 354-8644
NPI assigned
Nov 5, 2013
Last updated
Nov 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Authorized official

Name
Dr. Chanchai Sangsurasak, DDSNPI 1164652053
Title
President
Phone
(951) 354-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 58501 CA Primary

Addresses

Primary practice location

3410 La Sierra Ave
Suite D
Riverside, CA 92503-5270

Mailing address

3410 La Sierra Ave
Suite D
Riverside, CA 92503-5270
Phone (951) 354-9550

Other names 1

  • La Sierra Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3410 La Sierra Ave
Ste D
Riverside, CA 92503
Phone (951) 354-9550

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1164851747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 LA SIERRA AVE",
            "address_2": "SUITE D",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035270",
            "telephone_number": "951-354-9550",
            "fax_number": "951-354-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 LA SIERRA AVE",
            "address_2": "SUITE D",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035270",
            "telephone_number": "951-354-9550",
            "fax_number": "951-354-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANCHAI SANGSURASAK, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "SANGSURASAK",
        "authorized_official_first_name": "CHANCHAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-354-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Sierra Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.