Active NPI
Glenda Cruz Linchangco
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1366658783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 47937
- Practice address
- 6226 1 Half West Manchester Ave.
Los Angeles, CA 90045 - Phone
- (310) 215-9156
- Fax
- (310) 215-3479
- NPI assigned
- May 15, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 47937 | CA | Primary |
Addresses
Primary practice location
6226 1 Half West Manchester Ave.
Los Angeles, CA 90045
Mailing address
532 Ambridge St.
Lake Elsinore, CA 92532
Phone (714) 300-9759
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D47937 | 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 |
|---|---|---|---|
| 47937 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convalescent Dental Care | General Practice | Past | 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.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1982759148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1366658783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "532 AMBRIDGE ST.",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "92532",
"telephone_number": "714-300-9759",
"fax_number": "310-215-3479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6226 1 HALF WEST MANCHESTER AVE.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90045",
"telephone_number": "310-215-9156",
"fax_number": "310-215-3479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINCHANGCO",
"first_name": "GLENDA",
"middle_name": "CRUZ",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "47937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D47937",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.