South Pasadena General Dentistry Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25783 Issued in CA

Legal business name

SOUTH PASADENA GENERAL DENTISTRY INC

Practice address

1506 Huntington Drive
South Pasadena, CA 91030

Phone

(626) 799-2888

Fax

(626) 799-3208

NPI assigned

Aug 3, 2011

Organization subpart

No

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

Authorized official

Name

Susan Leung, DDSNPI 1922041433

Title

Director

Phone

(626) 799-2888

Specialties & licenses 1

Addresses

Other names 1

• Community Dental Inc. Former legal business name

Tax ID family

Community Dental Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Susan Leung DDS Inc

  • Dental Clinic/Center
  • South Pasadena, CA
  • NPI 1023454626
  NPD tax ID

Locations

Practitioners 2

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

• Susan Leung, DDS

  • General Practice Dentistry
  • South Pasadena, CA
  • NPI 1922041433
  NPD (past) Authorized official
• Aaron Bradley Tran

  • General Practice Dentistry
  • South Pasadena, CA
  • NPI 1639786817
  NPD (past)

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1831477124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 HUNTINGTON DRIVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "91030",
            "telephone_number": "626-799-2888",
            "fax_number": "626-799-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 HUNTINGTON DRIVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "91030",
            "telephone_number": "626-799-2888",
            "fax_number": "626-799-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PASADENA GENERAL DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "LEUNG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-799-2888",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Dental Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Heidi Grace Marie Soderholm, LMFT
• Elva Jessica Soto Calderon
• Ashley Sotomayor
• South Pasadena Care Center, LLC
• South Pasadena Chiropractic Wellness Center
• South Pasadena Optometric Group, Inc.
• South Pasadena Pediatrics, a Professional Corporation
• South Pasadena Rehabilitation Center, LLC
• Julissa Sparks, LPCC, NCC
• Daniel Fred Spector, PH.D.

• General Practice Dentistry in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.