Individual provider Active NPI

Ryan S Hong, DDS

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1417233891
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60681 Issued in CA
Practice address
438 N Lakeview Ave
Anaheim, CA 92807-3029
Phone
(714) 998-2553
NPI assigned
Oct 29, 2011
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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 60681 CA Primary

Addresses

Primary practice location

438 N Lakeview Ave
Anaheim, CA 92807-3029

Mailing address

1228 Rapidview Dr
Walnut, CA 91789-3825
Phone (909) 598-9960

Other practice location 1

1101 E Garvey Ave Ste 106
Monterey Park, CA 91755-3054
Phone (626) 288-8940

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
I20150923000496 CA Order and Referring Only - DentistPractitioner - Dentist 1759698756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gary a Luu D.D.S. Inc. General Practice PastSince Aug 2, 2020 Accepting new patients
Ryan S. Hong, DDS, Inc. General Practice Past Accepting new patients
Hoi Van Luu Dental Corp. Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1319846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1417233891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 RAPIDVIEW DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893825",
            "telephone_number": "909-598-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 N LAKEVIEW AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073029",
            "telephone_number": "714-998-2553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 E Garvey Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917553054",
            "country_code": "US",
            "telephone_number": "626-288-8940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HONG",
        "first_name": "RYAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-29",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.