Individual provider Active NPI

Danny Dandouch, OD

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1316668585
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35245 Issued in CA
Practice address
9589 Foothill Blvd
Rancho Cucamonga, CA 91730-3506
Phone
(909) 948-1875
NPI assigned
Sep 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35245 CA Primary

Addresses

Primary practice location

9589 Foothill Blvd
Rancho Cucamonga, CA 91730-3506

Mailing address

9589 Foothill Blvd
Rancho Cucamonga, CA 91730-3506
Phone (909) 948-1875

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
I20250501001872 CA Practitioner - Optometry 6507382686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35245CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Vibes Optometry, Inc. Optometrist CurrentSince Feb 1, 2025 Accepting new patients

Locations

9589 Foothill Blvd
Rancho Cucamonga, CA 91730
Phone (909) 466-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1316668585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9589 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303506",
            "telephone_number": "909-948-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9589 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303506",
            "telephone_number": "909-948-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDOUCH",
        "first_name": "DANNY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.