Marian B Afurong, DMD
Individual provider Active NPI General Practice Dentistry · Hacienda Heights, CA
NPI 1720122351 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720122351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 31020 (CA)
- Practice address
- 2440 S Hacienda Blvd
Suite 203
Hacienda Heights, CA 91745-4775 - Phone
- (626) 968-2020
- Fax
- (626) 968-7021
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170412000457 | CA | Order and Referring Only - Oral Surgery |
0042596728 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31020 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. M. Afurong, DDS Inc. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31020 | CA | Yes |
Addresses
Primary practice location
2440 S Hacienda Blvd
Suite 203
Hacienda Heights, CA 91745-4775
Mailing address
2440 S Hacienda Blvd
Suite 203
Hacienda Heights, CA 91745-4775
Phone (626) 968-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 231020 | Other | CA | MEDI-CAL PROVIDER NUMBER |
Other providers in Hacienda Heights, CA
- Access Primary Care Physicians, Inc.
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- Irmina Adelya
- Adult & Child Allergy-Asthma Clinic Inc
- Advanced Performance Chiropractic Inc.
- Laura Aguilar Villagomez
- Jesus Aguilar
- Angelica Aguirre
- Charlene Ahn
- Darius Aiko
All providers in Hacienda Heights, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.