Individual provider Active NPI

Van Ngoc Dang, D.D.S

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1467590109
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50134 Issued in CA
Practice address
9275 E Stockton Blvd Ste 200
Elk Grove, CA 95624-5067
Phone
(916) 688-1990
Fax
(916) 688-5467
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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 50134 CA Primary

Addresses

Primary practice location

9275 E Stockton Blvd Ste 200
Elk Grove, CA 95624-5067

Mailing address

9275 E Stockton Blvd Ste 200
Elk Grove, CA 95624-5067
Phone (916) 688-1990

Other identifiers 3

IdentifierTypeStateIssuer
B50134-02OtherCAHEALTHY FAMILIES ID #
001643881OtherCAUNITED CONCORDIA ID #
721587144OtherCATAX IDENTIFICATION NUMBER

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
50134CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Van Dang, D.D.S., a Professional Dental Corporation CurrentSince Sep 1, 2024 Accepting new patients

Locations

9275 E Stockton Blvd
Ste 200
Elk Grove, CA 95624
Phone (916) 688-1990

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1467590109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9275 E STOCKTON BLVD STE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245067",
            "telephone_number": "916-688-1990",
            "fax_number": "916-688-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9275 E STOCKTON BLVD STE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245067",
            "telephone_number": "916-688-1990",
            "fax_number": "916-688-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "VAN",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES ID #",
            "identifier": "B50134-02",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID #",
            "identifier": "001643881",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "721587144",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.