Active NPI
Chong O Altenburg, RDHAP
- Dental Hygienist
- Rialto, CA
National Provider Identifier
1285999375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 417
- Practice address
- 3993 Larkspur Ave
Rialto, CA 92377-3581 - Phone
- (909) 997-7197
- Fax
- (909) 574-2644
- NPI assigned
- Jul 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 417 | CA | Primary |
Addresses
Primary practice location
3993 Larkspur Ave
Rialto, CA 92377-3581
Mailing address
3993 Larkspur Ave
Rialto, CA 92377-3581
Phone (909) 997-7197
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
| License | State | Type | Specialty |
|---|---|---|---|
| 417 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341446400000",
"number": "1285999375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3993 LARKSPUR AVE",
"city": "RIALTO",
"state": "CA",
"postal_code": "923773581",
"telephone_number": "909-997-7197",
"fax_number": "909-574-2644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3993 LARKSPUR AVE",
"city": "RIALTO",
"state": "CA",
"postal_code": "923773581",
"telephone_number": "909-997-7197",
"fax_number": "909-574-2644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTENBURG",
"first_name": "CHONG",
"middle_name": "O",
"name_prefix": "Mrs.",
"credential": "RDHAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-05",
"last_updated": "2012-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.