Individual provider Active NPI

Hongsheng Sam Tong, DDS, PHD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Riverside, CA
National Provider Identifier
1528120797
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
45037 Issued in CA
Practice address
11705 Slate Ave Ste 150
Riverside, CA 92505-7119
Phone
(951) 689-8021
Fax
(951) 689-8025
NPI assigned
Dec 14, 2006
Last updated
Nov 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 45037 CA Primary

Addresses

Primary practice location

11705 Slate Ave Ste 150
Riverside, CA 92505-7119

Mailing address

20360 Via Manresa
Yorba Linda, CA 92887-3209
Phone (714) 779-1392

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
45037CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
H Sam Tong DDS PHD Inc, a Professional Corporation Orthodontics and Dentofacial Orthopedics Past Accepting new patients

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": "1320710400000",
    "number": "1528120797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20360 VIA MANRESA",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928873209",
            "telephone_number": "714-779-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 SLATE AVE STE 150",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925057119",
            "telephone_number": "951-689-8021",
            "fax_number": "951-689-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONG",
        "first_name": "HONGSHENG",
        "middle_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "45037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.