Individual provider Active NPI

Nam D Dang, DDS

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1417059163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49718 Issued in CA
Practice address
4482 Barranca Pkwy
Ste. 195
Irvine, CA 92604-7701
Phone
(949) 653-7700
Fax
(949) 653-7747
NPI assigned
Sep 2, 2006
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 49718 CA Primary

Addresses

Primary practice location

4482 Barranca Pkwy
Ste. 195
Irvine, CA 92604-7701

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 508-3600

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
I20150922000553 CA Order and Referring Only - DentistPractitioner - Dentist 6507173622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49718CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417059163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY",
            "address_2": "STE. 195",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926047701",
            "telephone_number": "949-653-7700",
            "fax_number": "949-653-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "NAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.