Active NPI
Stanley Hong
- Dentist
- Temecula, CA
National Provider Identifier
1538216536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57103
- Practice address
- 30571 Temecula Pkwy Ste D
Temecula, CA 92592-4821 - Phone
- (951) 693-2079
- Fax
- (951) 699-6720
- NPI assigned
- Jan 4, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12010674 | IN | |
| Dentist | 122300000X | 57103 | CA | Primary |
Addresses
Primary practice location
30571 Temecula Pkwy Ste D
Temecula, CA 92592-4821
Mailing address
30571 Temecula Pkwy Ste D
Temecula, CA 92592-4821
Phone (951) 693-2079
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 |
|---|---|---|---|---|
| I20150728006173 | CA | Order and Referring Only - Dentist | 9335453869 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010674 | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sahawneh Dental Corporation | Dentist | 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": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1538216536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30571 TEMECULA PKWY STE D",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925924821",
"telephone_number": "951-693-2079",
"fax_number": "951-699-6720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30571 TEMECULA PKWY STE D",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925924821",
"telephone_number": "951-693-2079",
"fax_number": "951-699-6720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HONG",
"first_name": "STANLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12010674",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.