Individual provider Active NPI

Jane Vo

  • Dental Assistant
  • Garden Grove, CA
National Provider Identifier
1255956678
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
RDA92829 Issued in CA
Practice address
11821 Palmwood Dr
Garden Grove, CA 92840-2016
Phone
(714) 254-5577
NPI assigned
Jun 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X RDA92829 CA Primary

Addresses

Primary practice location

11821 Palmwood Dr
Garden Grove, CA 92840-2016

Mailing address

11821 Palmwood Dr
Garden Grove, CA 92840-2016
Phone (714) 254-5577

Other identifiers 1

IdentifierTypeStateIssuer
RDA92829MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RDA92829CAMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1255956678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11821 PALMWOOD DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402016",
            "telephone_number": "714-254-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11821 PALMWOOD DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402016",
            "telephone_number": "714-254-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA92829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RDA92829",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.