Active NPI
Antono Teang, DDS
- General Practice Dentistry
- Rosemead, CA
National Provider Identifier
1215224407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61916
- Practice address
- 4100 Rosemead Blvd
Coast Dental
Rosemead, CA 91770-4404 - Phone
- (626) 575-1161
- NPI assigned
- Jul 7, 2011
- Last updated
- Jan 2, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61916 | CA | Primary |
Addresses
Primary practice location
4100 Rosemead Blvd
Coast Dental
Rosemead, CA 91770-4404
Mailing address
4100 Rosemead Blvd
Coast Dental
Rosemead, CA 91770-4404
Phone (626) 575-1161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170228000748 | CA | Order and Referring Only - Other (Non-Physician) | 6103100748 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61916 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Dental Services | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357084800000",
"number": "1215224407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 ROSEMEAD BLVD",
"address_2": "COAST DENTAL",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917704404",
"telephone_number": "626-575-1161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 ROSEMEAD BLVD",
"address_2": "COAST DENTAL",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917704404",
"telephone_number": "626-575-1161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEANG",
"first_name": "ANTONO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-07",
"last_updated": "2013-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "61916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosemead, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.