Yawen Peng

Primary specialty

DentistTaxonomy code 122300000X

License

54621 Issued in CA

Practice address

4606 Hollywood Blvd Ste B
Los Angeles, CA 90027

Phone

(323) 663-3850

NPI assigned

Jan 10, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

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.

• Children'S Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment NPD
• Yawen Peng DMD Incorporated

  • Dental Clinic/Center
  • Los Angeles, CA
  • NPI 1700405123
  NPD (past) Authorized official
• Jeffrie Maneepetasut DMD Inc

  • Dentist
  • Los Angeles, CA
  • NPI 1285815340
  NPD (past)

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1255517009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 HOLLYWOOD BLVD STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275462",
            "telephone_number": "323-663-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 HOLLYWOOD BLVD STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-663-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "YAWEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21710",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilin Peng, LMFT
• Luon W Peng, DO
• Micalla Grace Peng, MD
• Tammy Peng, M.D.
• Terrance Peng, MD
• Honorine Penoria Pengho, NP
• Elliot Penhasian, DDS
• Marisol Garcia Penichet, M.D.
• Mikel-Claire Alexandria Penick, MSW
• Ratana Penkingcarn

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.