Individual provider Active NPI

Dennis Cheng, OD

  • Optometrist
  • West Covina, CA
National Provider Identifier
1497817886
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT9221 Issued in CA
Practice address
2707 E Valley Blvd
#117
West Covina, CA 91792-3195
Phone
(626) 839-1800
Fax
(626) 839-1802
NPI assigned
Dec 14, 2006
Last updated
Oct 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT9221 CA Primary

Addresses

Primary practice location

2707 E Valley Blvd
#117
West Covina, CA 91792-3195

Mailing address

2707 E Valley Blvd
#117
West Covina, CA 91792-3195
Phone (626) 839-1800

Other identifiers 3

IdentifierTypeStateIssuer
6227OtherCAVSP
49153OtherCASAFEGUARD
SD0092211MedicaidCA

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
I20120125000478 CA Practitioner - Optometry 9234306663 Practice locations: West Covina, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2707 E Valley Blvd
Suite 117
West Covina, CA 91792-3196
Phone (626) 839-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT9221CAMDOptometrist
9221CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Cheng OD Optometrist CurrentSince Mar 16, 1994 Accepting new patients

Locations

2707 E Valley Blvd
Ste 117
West Covina, CA 91792
Phone (626) 839-1800

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, 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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1497817886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 E VALLEY BLVD",
            "address_2": "#117",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923195",
            "telephone_number": "626-839-1800",
            "fax_number": "626-839-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 E VALLEY BLVD",
            "address_2": "#117",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923195",
            "telephone_number": "626-839-1800",
            "fax_number": "626-839-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT9221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "6227",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD",
            "identifier": "49153",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0092211",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.