Individual provider Active NPI

Justin Cheng, DDS

  • General Practice Dentistry
  • Fremont, CA
National Provider Identifier
1386808350
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46571 Issued in CA
Practice address
38155 Martha Ave
Fremont, CA 94536-3800
Phone
(510) 796-1263
Fax
(510) 796-9524
NPI assigned
Jul 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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 46571 CA Primary

Addresses

Primary practice location

38155 Martha Ave
Fremont, CA 94536-3800

Mailing address

38155 Martha Ave
Fremont, CA 94536-3800
Phone (510) 796-1263

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

LicenseStateTypeSpecialty
46571CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1386808350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38155 MARTHA AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363800",
            "telephone_number": "510-796-1263",
            "fax_number": "510-796-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38155 MARTHA AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363800",
            "telephone_number": "510-796-1263",
            "fax_number": "510-796-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "JUSTIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.