Eric C.K. Peng, DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ERIC C.K. PENG, DDS, INC.

Practice address

7615 Garvey Ave
Rosemead, CA 91770-3001

Phone

(626) 307-4078

Fax

(626) 307-9432

NPI assigned

Aug 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Eric Chich-Kuang Peng, DDS

Title

President

Phone

(626) 307-4078

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Chich-Kuang Eric Peng, D.D.S.

  • General Practice Dentistry
  • Rosemead, CA
  • NPI 1891803714
  NPD

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

{
    "created_epoch": "1188000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1184817868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 GARVEY AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703001",
            "telephone_number": "626-307-4078",
            "fax_number": "626-307-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 GARVEY AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703001",
            "telephone_number": "626-307-4078",
            "fax_number": "626-307-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC C.K. PENG, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-25",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "CHICH-KUANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-307-4078",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "35017",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93553-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Rosemead, CA
• Providers in Rosemead, 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 Jun 14, 2021; 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.