NPIMap

Organization Active NPI

Sandra J Gong DDS Dental Corp.

  • General Practice Dentistry
  • Arvin, CA
National Provider Identifier
1285775502
Registry record updated Oct 3, 2014
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29891 Issued in CA
Legal business name
SANDRA J GONG DDS DENTAL CORP.
Practice address
101 Comanche Dr
Arvin, CA 93203-0172
Phone
(661) 854-5558
Fax
(661) 854-2696
NPI assigned
Feb 9, 2007
Last updated
Oct 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Dr. Sandra J Gong, DDS
Title
Chief Executive Officer
Phone
(661) 854-5558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 29891 CA Primary

Addresses

Primary practice location

101 Comanche Dr
Arvin, CA 93203-0172

Mailing address

PO Box 172
Arvin, CA 93203-0172
Phone (661) 854-5558

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1285775502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172",
            "city": "ARVIN",
            "state": "CA",
            "postal_code": "932030172",
            "telephone_number": "661-854-5558",
            "fax_number": "661-854-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COMANCHE DR",
            "city": "ARVIN",
            "state": "CA",
            "postal_code": "932030172",
            "telephone_number": "661-854-5558",
            "fax_number": "661-854-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA J GONG DDS DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "GONG",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "661-854-5558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.