Rong Pan, D.D.S., Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RONG PAN, D.D.S., INC.

Practice address

5150 Graves Ave Ste 11D
San Jose, CA 95129-5014

Phone

(408) 255-0033

NPI assigned

Dec 15, 2021

Organization subpart

No

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

Authorized official

Name

Yi Wang

Title

President

Phone

(408) 255-0033

Specialties & licenses 1

Addresses

Other names 1

• Rong Pan, D.D.S., Inc. Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rong Pan, DDS

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1508886334
  NPD
• Sooyoung Kim, DMD

  • Endodontics
  • Mountain View, CA
  • NPI 1578838454
  NPD (past)

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1609535764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18180 SAGE CT",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704500",
            "telephone_number": "408-255-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE STE 11D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295014",
            "telephone_number": "408-255-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONG PAN, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "YI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-255-0033"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rong Pan, D.D.S., Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Glenn R. Romualdo, MD
• Ron Rosen, M.D., Inc
• Ronald a Restifo MD a Prof Corp
• Ronald C. Diebel, M.D. a Professional Corporation
• Ronald R Uyeyama M D Inc
• Hao Rong, D.D.S
• Wenqiang Rong, DDS
• Claudine Lauren Ronquillo
• Shayda Roohparvar
• Rebecca Marie Rook, ACSW

• Dental Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.