Eugene Peng

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106619 Issued in CA

Practice address

270 26TH St Ste 301
Santa Monica, CA 90402-2567

Phone

(310) 394-2796

NPI assigned

Mar 15, 2020

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anfruns Henderson and Kane Dental Partnership

  • General Practice Dentistry
  • Santa Monica, CA
  • NPI 1588385462
  NPD

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

{
    "created_epoch": "1584230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1194351718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11435 TIARA ST APT 5",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916011137",
            "telephone_number": "617-894-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 26TH ST STE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022567",
            "telephone_number": "310-394-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taksina Pelaez
• Peter C Pelikan, M.D.
• Pelvica Physical Therapy, Inc.
• Anna Sekora Pendry
• Valeria Ana Penela, PSY. D, PSYCHOLOGIST
• Kerui Peng
• Jennifer E Peragine, M.S., CCC-SLP
• Diana Romero Peraza
• Aaron Jacob Perecman, MD
• Neftali Pereda

• General Practice Dentistry in Santa Monica, CA
• Providers in Santa Monica, 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 Feb 15, 2022; 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.