Individual provider Active NPI

Wen-Hong Felix Peng, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Gardena, CA
National Provider Identifier
1619091154
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DDS46124 Issued in CA
Practice address
1700 W Gardena Blvd
Gardena, CA 90247-4727
Phone
(310) 323-0689
Fax
(310) 323-0108
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 46124 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DDS46124 CA Primary

Addresses

Primary practice location

1700 W Gardena Blvd
Gardena, CA 90247-4727

Mailing address

11301 W Olympic Blvd # 702
Los Angeles, CA 90064-1653
Phone (310) 308-3204

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
I20180215001397 CA Practitioner - Oral Surgery 6103147913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46124CAMDMarriage & Family Therapist
DDS46124CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Peng Dental Corp Current Accepting new patients

Locations

11301 W Olympic Blvd
#702
Los Angeles, CA 90064

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1619091154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 W OLYMPIC BLVD # 702",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641653",
            "telephone_number": "310-308-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W GARDENA BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474727",
            "telephone_number": "310-323-0689",
            "fax_number": "310-323-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "WEN-HONG",
        "middle_name": "FELIX",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46124",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS46124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.