Gabriella Pung, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

108121 Issued in CA

Practice address

7540 Orangethorpe Ave Ste A1
Buena Park, CA 90621-3458

Phone

(714) 576-2540

NPI assigned

May 31, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Swati Shetty Dental Corporation

  dba Dentists of Buena Park Dental Group

  • Dentist
  • Buena Park, CA
  • NPI 1023515558
  NPD (past)

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1417696410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8312 ATLANTA AVE APT 102",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926466162",
            "telephone_number": "920-379-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 ORANGETHORPE AVE STE A1",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906213458",
            "telephone_number": "714-576-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNG",
        "first_name": "GABRIELLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prajakta Deshpande, MD
• Premierone Plus Ids
• PSB Homes Inc. Dracaena Homes
• Jessica H Pulido, ASW
• Louisa Pumpruck, SLPA
• Jaclyn Hyejin Pyun, D.D.S.
• Nichole Amber Quick, M.D.
• Quynh Ngo DMD Inc (Quinn Ngo Dental Practice)
• Emily Tate Raber, ATC
• Rabizadeh DDS Apdc (buena park smile dental group)

• General Practice Dentistry in Buena Park, CA
• Providers in Buena Park, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.