Individual provider Active NPI

Dianne Tungol, DDS

  • Dentist
  • Riverside, CA
National Provider Identifier
1801102389
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59685 Issued in CA
Practice address
8856 Arlington Ave
Riverside, CA 92503-1365
Phone
(951) 710-3970
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59685 CA Primary

Addresses

Primary practice location

8856 Arlington Ave
Riverside, CA 92503-1365

Mailing address

6961 Schaefer Ave
Chino, CA 91710-9126
Phone (909) 590-0640

Other practice location 1

6961 Schaefer Ave
Chino, CA 91710-9126
Phone (909) 590-0640

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
I20150716003252 CA Order and Referring Only - DentistPractitioner - Dentist 1951614163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59685CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sambangi and Rodgers Dental Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dtungol684928@direct.ochin.org

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1801102389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6961 SCHAEFER AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917109126",
            "telephone_number": "909-590-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8856 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925031365",
            "telephone_number": "951-710-3970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6961 Schaefer Ave",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917109126",
            "country_code": "US",
            "telephone_number": "909-590-0640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUNGOL",
        "first_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.