Angela Miaoxin Du, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

105612 Issued in CA

Practice address

2190 E Bidwell St
Folsom, CA 95630-6453

Phone

(916) 984-0304

NPI assigned

Sep 28, 2020

Last updated

Sep 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• S.Y. Jang DDS Corporatiom

  dba Make A Smile

  • Pediatric Dentistry
  • Folsom, CA
  • NPI 1194115154
  NPD (past)
• Tavallaei, D.M.D., Corporation

  dba Make a Smile

  • Pediatric Dentistry
  • Folsom, CA
  • NPI 1538225503
  NPD (past)

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725148800000",
    "number": "1255948741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 5TH ST APT 320",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052797",
            "telephone_number": "424-270-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 E BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306453",
            "telephone_number": "916-984-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU",
        "first_name": "ANGELA",
        "middle_name": "MIAOXIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105612",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "105612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Kayla Trejo, Psychology Inc
• Dr. Palmer N. Lee, OD Inc (EYEcenter Optometric)
• Jay Thomas Draeger, M.D.
• Melissa Elizabeth Drivon
• Todd Jason Drybread, D.C.
• Gaurett Bettencourt Duckhorn, MS PT
• Christopher Ducombs
• Marissa Duenas
• J. Patrick Dunbar, D.D.S.
• Richard William Dunbar, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2024; 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.