Individual provider Active NPI

Leslie Wan-Yi Tay, DMD

  • Pediatric Dentistry
  • Chino Hills, CA
National Provider Identifier
1740808435
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
105912 Issued in CA
Practice address
3410 Grand Ave Ste F
Chino Hills, CA 91709-1473
Phone
(909) 364-0027
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 105912 CA Primary

Addresses

Primary practice location

3410 Grand Ave Ste F
Chino Hills, CA 91709-1473

Mailing address

235 Coal Mine
Irvine, CA 92602-1921
Phone (916) 712-4228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231025001675 CA Order and Referring Only - DentistPractitioner - Dentist 1951757004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rodgers and Sambangi Dental Corporation General Practice PastSince Jul 16, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1740808435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 COAL MINE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021921",
            "telephone_number": "916-712-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 GRAND AVE STE F",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091473",
            "telephone_number": "909-364-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAY",
        "first_name": "LESLIE",
        "middle_name": "WAN-YI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "105912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.