NPIMap

Organization Active NPI

Wan Peng DDS a Professional Corp.

  • General Practice Dentistry
  • El Cajon, CA
National Provider Identifier
1700076858
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44985 Issued in CA
Legal business name
WAN PENG DDS A PROFESSIONAL CORP.
Practice address
1106 N 2ND St
El Cajon, CA 92021-5008
Phone
(619) 442-3131
Fax
(619) 442-8445
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Dr. Wan Peng, DDSNPI 1083766653
Title
President/Dentist
Phone
(619) 442-3131

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 44985 CA Primary

Addresses

Primary practice location

1106 N 2ND St
El Cajon, CA 92021-5008

Mailing address

1106 N 2ND St
El Cajon, CA 92021-5008
Phone (619) 442-3131

National Provider Directory

National Provider Directory

Locations

1106 N 2nd St
El Cajon, CA 92021
Phone (619) 442-3131

Practitioners & affiliated clinicians

Practitioners 2

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1700076858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N 2ND ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215008",
            "telephone_number": "619-442-3131",
            "fax_number": "619-442-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N 2ND ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215008",
            "telephone_number": "619-442-3131",
            "fax_number": "619-442-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAN PENG DDS A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "WAN",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "619-442-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.