Active NPI
Duong Ha
- General Practice Dentistry
- Anaheim, CA
National Provider Identifier
1457665705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 59400
- Practice address
- 518 S Eveningsong LN
Anaheim, CA 92808-1615 - Phone
- (714) 269-0645
- NPI assigned
- Jul 28, 2010
- Sex
- Male
- 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 | 59400 | CA | Primary |
Addresses
Primary practice location
518 S Eveningsong LN
Anaheim, CA 92808-1615
Mailing address
518 S Eveningsong LN
Anaheim, CA 92808-1615
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170113002431 | CA | Order and Referring Only - Dentist | 4688956287 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59400 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1457665705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "518 S EVENINGSONG LN",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928081615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 S EVENINGSONG LN",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928081615",
"telephone_number": "714-269-0645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HA",
"first_name": "DUONG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-28",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "59400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.