David T Dang, DDS
Individual provider Active NPI Dentist · La Puenta, CA
NPI 1295842441 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295842441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 52975 (CA)
- Practice address
- 1419 North Hacienda Blvd
La Puenta, CA 91744 - Phone
- (626) 917-5830
- Fax
- (626) 918-3538
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 10, 2023 through Jan 10, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 52975 | CA | Yes |
Addresses
Primary practice location
1419 North Hacienda Blvd
La Puenta, CA 91744
Mailing address
1419 North Hacienda Blvd
La Puenta, CA 91744
Phone (626) 917-5830
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.