Individual provider Active NPI

Glenn Lanzar Ong-Veloso, D.D.S,MPH

  • General Practice Dentistry
  • Apple Valley, CA
National Provider Identifier
1326193327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44347 Issued in CA
Practice address
15995 Tuscola Rd Ste 201
Apple Valley, CA 92307-2159
Phone
(760) 242-2620
Fax
(760) 242-4700
NPI assigned
Jan 23, 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
General Practice Dentistry 1223G0001X 44347 CA Primary

Addresses

Primary practice location

15995 Tuscola Rd Ste 201
Apple Valley, CA 92307-2159

Mailing address

15995 Tuscola Rd Ste 201
Apple Valley, CA 92307-2159
Phone (760) 242-2620

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
I20150818003351 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779898960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44347CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Ong- Veloso DDS Inc PastSince May 1, 2010 Accepting new patients

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326193327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15995 TUSCOLA RD STE 201",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072159",
            "telephone_number": "760-242-2620",
            "fax_number": "760-242-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15995 TUSCOLA RD STE 201",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072159",
            "telephone_number": "760-242-2620",
            "fax_number": "760-242-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG-VELOSO",
        "first_name": "GLENN",
        "middle_name": "LANZAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S,MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.