Individual provider Active NPI

Jiunn Der Hwang, DDS

  • Periodontics
  • Arcadia, CA
National Provider Identifier
1295867349
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
36560 Issued in CA
Practice address
632 W Duarte Rd Ste 160
Arcadia, CA 91007-7611
Phone
(626) 447-8255
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 36560 CA Primary

Addresses

Primary practice location

632 W Duarte Rd Ste 160
Arcadia, CA 91007-7611

Mailing address

632 W Duarte Rd Ste 160
Arcadia, CA 91007-7611
Phone (626) 447-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161007001538 CA Order and Referring Only - DentistPractitioner - Dentist 1052609922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295867349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W DUARTE RD STE 160",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077611",
            "telephone_number": "626-447-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W DUARTE RD STE 160",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077611",
            "telephone_number": "626-447-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "JIUNN DER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "36560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.