Active NPI
Catherine Tuyet Mai Dang, DMD
- General Practice Dentistry
- Rohnert Park, CA
National Provider Identifier
1548885445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS107468
- Practice address
- 5900 State Farm Dr FL 2
Rohnert Park, CA 94928-2149 - Phone
- (707) 559-7500
- NPI assigned
- Jun 16, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | DDS107468 | CA | Primary |
Addresses
Primary practice location
5900 State Farm Dr FL 2
Rohnert Park, CA 94928-2149
Mailing address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7130
Other practice location 1
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7130
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 |
|---|---|---|---|---|
| I20231115000402 | CA | Order and Referring Only - Dentist | 7113374000 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS107468 | CA | MD | General Practice Dentistry |
Interoperability endpoints
- catherine.dang@edchc.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1548885445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5501 OLD YORK RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413018",
"telephone_number": "215-456-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 STATE FARM DR FL 2",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "949282149",
"telephone_number": "707-559-7500"
}
],
"practiceLocations": [
{
"address_1": "5501 Old York Rd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191413018",
"country_code": "US",
"telephone_number": "215-456-7130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DANG",
"first_name": "CATHERINE",
"middle_name": "TUYET MAI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS107468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rohnert Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.