Peng Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

46124 Issued in CA

Legal business name

PENG DENTAL CORP

Practice address

1700 W Gardena Blvd
Gardena, CA 90247-4727

Phone

(310) 323-0689

NPI assigned

Jul 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Wenhong Felix Peng, DDSNPI 1619091154

Title

President

Phone

(310) 308-3204

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

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

• Wen-Hong Felix Peng, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Gardena, CA
  • NPI 1619091154
  Medicare reassignment Authorized official
• Michael Kiyoshi Dote, D.D.S.

  • General Practice Dentistry
  • Gardena, CA
  • NPI 1619015260
  NPD (past)
• Allen T Sueoka, D.D.S.

  • General Practice Dentistry
  • Gardena, CA
  • NPI 1992842330
  NPD (past)
• Kazunobu Ernest Terao, D.D.S.

  • General Practice Dentistry
  • Gardena, CA
  • NPI 1194751479
  NPD (past)

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246406400000",
    "number": "1689802324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W GARDENA BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474727",
            "telephone_number": "310-323-0689"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENG DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "WENHONG",
        "authorized_official_middle_name": "FELIX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-308-3204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "46124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben Pena
• Sonia Pena, AMFT
• Janet Penaloza
• Patricia Penaloza
• Nicolette Naijah Maire Pendleton
• Wen-Hong Felix Peng, D.D.S.
• Alex Eli Pensamiento
• Elizabeth Peralta
• Bailey Peraza
• Carlos Perdomo

• Dental Clinic/Center in Gardena, CA
• Providers in Gardena, 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 Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.