Active NPI
Jurie Du Fang, D.D.S.
- General Practice Dentistry
- La Habra, CA
National Provider Identifier
1700942992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 41074
- Practice address
- 2096 W. la Habra Blvd
La Habra, CA 90631-5007 - Phone
- (562) 905-1828
- Fax
- (562) 905-1180
- NPI assigned
- Dec 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 41074 | CA | Primary |
Addresses
Primary practice location
2096 W. la Habra Blvd
La Habra, CA 90631-5007
Mailing address
2096 W. la Habra Blvd
La Habra, CA 90631-5007
Phone (562) 905-1828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D41074 | Other | CA | DENTI-CAL RENDERING PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41074 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James Fang, D.D.S., Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Star Dental Practice
- General Practice Dentistry
- La Habra, CA
- NPI 1932316411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1700942992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2096 W. LA HABRA BLVD",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906315007",
"telephone_number": "562-905-1828",
"fax_number": "562-905-1180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2096 W. LA HABRA BLVD",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906315007",
"telephone_number": "562-905-1828",
"fax_number": "562-905-1180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANG",
"first_name": "JURIE",
"middle_name": "DU",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "41074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL RENDERING PIN",
"identifier": "D41074",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Habra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.