Individual provider Active NPI

Darin Fong, D.D.S.

  • Dentist
  • Huntington Beach, CA
National Provider Identifier
1679739569
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41079 Issued in CA
Practice address
8907 Warner Ave
Suite 100
Huntington Beach, CA 92647-5075
Phone
(714) 848-7777
NPI assigned
Jul 31, 2008
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41079 CA Primary

Addresses

Primary practice location

8907 Warner Ave
Suite 100
Huntington Beach, CA 92647-5075

Mailing address

8907 Warner Ave
Suite 100
Huntington Beach, CA 92647-5075
Phone (714) 848-7777

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150625000091 CA Order and Referring Only - Other (Non-Physician) 7113238601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41079CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Darin Fong DDS Inc. PastSince Jun 21, 2020 Accepting new patients
21St Century Dental Past Accepting new patients

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, 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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1679739569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8907 WARNER AVE",
            "address_2": "SUITE 100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475075",
            "telephone_number": "714-848-7777",
            "fax_number": "714-848-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8907 WARNER AVE",
            "address_2": "SUITE 100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475075",
            "telephone_number": "714-848-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "DARIN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.