Active NPI
Annie Dang
- Dental Assistant
- Baldwin Park, CA
National Provider Identifier
1295399004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 75440
- Practice address
- 4000 La Rica Ave Ste D
Baldwin Park, CA 91706-3163 - Phone
- (626) 598-8484
- NPI assigned
- Apr 26, 2019
- Sex
- Female
- Sole proprietor
- No
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 Assistant | 126800000X | 75440 | CA | Primary |
Addresses
Primary practice location
4000 La Rica Ave Ste D
Baldwin Park, CA 91706-3163
Mailing address
813 N Langham Ave
Covina, CA 91724-2522
Phone (626) 927-7640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 75440 | Medicaid | CA |
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 |
|---|---|---|---|
| 75440 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1295399004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 N LANGHAM AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917242522",
"telephone_number": "626-927-7640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 LA RICA AVE STE D",
"city": "BALDWIN PARK",
"state": "CA",
"postal_code": "917063163",
"telephone_number": "626-598-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANG",
"first_name": "ANNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-26",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "75440",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "75440",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baldwin Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.