Organization Active NPI

Prerna Garg DDS Inc

  • Dentist
  • Riverside, CA
National Provider Identifier
1720801798
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PRERNA GARG DDS INC
Doing business as
Wiz Kids Dental
Practice address
3845 La Sierra Ave Ste 101B
Riverside, CA 92505-3594
Phone
(857) 265-0880
NPI assigned
Nov 6, 2024
Organization subpart
Yes
Parent organization
PRERNA GARG DDS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Prerna GargNPI 1285144980
Title
Ceo
Phone
(857) 265-0880

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 SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3845 La Sierra Ave Ste 101B
Riverside, CA 92505-3594

Mailing address

90 Vantis Dr Unit 1122
Aliso Viejo, CA 92656-2506

Other names 1

  • Wiz Kids Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Prerna Garg DDS Inc

Locations

3845 La Sierra Ave
Ste 101B
Riverside, CA 92505
Phone (857) 265-0880

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": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1720801798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 VANTIS DR UNIT 1122",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 LA SIERRA AVE STE 101B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053594",
            "telephone_number": "857-265-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRERNA GARG DDS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRERNA GARG DDS INC",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "GARG",
        "authorized_official_first_name": "PRERNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "857-265-0880"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wiz Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.