Wonderful Life Dental Group

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WONDERFUL LIFE DENTAL GROUP

Practice address

10470 Foothill Blvd # 250
Rancho Cucamonga, CA 91730-3754

Phone

(626) 757-9906

NPI assigned

Sep 16, 2024

Organization subpart

No

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

Authorized official

Name

Jack PaiNPI 1447778220

Title

Ceo

Phone

(626) 757-9906

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Pai, DDS

  • Dentist
  • Rancho Cucamonga, CA
  • NPI 1447778220
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1801623871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 FOOTHILL BLVD # 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303754",
            "telephone_number": "626-757-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 FOOTHILL BLVD # 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303754",
            "telephone_number": "626-757-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERFUL LIFE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "PAI",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-757-9906"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronette Letania Wolfe
• Victoria Wolfe
• Joshua Womack
• Wombat Mental Health Services a LCSW Professional Corporation
• Women'S Medical Group of Upland Inc.
• Alex Wong
• Chris Wong
• Corinne Francine Wong, OD
• Eric Shall-Kit Wong, DMD, MS
• Vivian Wong, OTR/L

• Dental Clinic/Center in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.