NPIMap

Organization Active NPI

Simonwongddsinc

Doing business as california dentures

  • Dentist
  • Glendale, CA
National Provider Identifier
1689912131
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49430 Issued in CA
Legal business name
SIMONWONGDDSINC
Doing business as
california dentures
Practice address
932 N. Brand Blvd
Glendale, CA 91202-2982
Phone
(818) 246-4068
NPI assigned
Jan 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Dr. Simon Wong, D.D.S.NPI 1740245646
Title
President
Phone
(818) 246-4068

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 49430 CA Primary

Addresses

Primary practice location

932 N. Brand Blvd
Glendale, CA 91202-2982

Mailing address

932 N Brand Blvd
Glendale, CA 91202-2905
Phone (818) 246-4068

Other names 1

  • california dentures Doing business as

National Provider Directory

National Provider Directory

Locations

932 N Brand Blvd
Glendale, CA 91202
Phone (818) 246-4068

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1689912131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 N BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022905",
            "telephone_number": "818-246-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 N. BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022982",
            "telephone_number": "818-246-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMONWONGDDSINC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-246-4068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "49430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "california dentures",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.