Alfonse Doan

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

60382 Issued in CA

Practice address

3648 S Mooney Blvd
Visalia, CA 93277-8019

Phone

(559) 389-7019

NPI assigned

Jun 7, 2011

Last updated

Jun 7, 2011By 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

Other names 1

• Phong An Doan Former name

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

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.

• Doan DDS and Lee DDS, a Dental Corporation

  • Pediatric Dentistry
  • Tracy, CA
  • NPI 1275316283
  NPD Authorized official
• Kaweah Dental Inc

  dba Kaweah Dental

  • General Practice Dentistry
  • Visalia, CA
  • NPI 1225466436
  NPD (past)

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1205120219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3648 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778019",
            "telephone_number": "559-389-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "ALFONSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "60382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHONG",
            "last_name": "DOAN",
            "middle_name": "AN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jorge A Dimas, MPT
• Abiezer Natanael Disla Cuevas, MD
• Craig Jensen Dixon
• Aissa Health DO, DO
• Christine DO, DO
• Christopher Doan, MD
• Philip Huy Doan, DDS
• April L Dodd, LMFT
• Grady Deshawn Dodson, ASW
• Preslie Mikah Doherty

• Pediatric Dentistry in Visalia, CA
• Providers in Visalia, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.