Individual provider Active NPI

Casey Ching La, DMD

  • General Practice Dentistry
  • Riverside, CA
National Provider Identifier
1871281634
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109006 Issued in CA
Practice address
12448 Orangeblossom LN
Riverside, CA 92503-7057
Phone
(951) 329-0372
NPI assigned
Apr 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 109006 CA Primary

Addresses

Primary practice location

12448 Orangeblossom LN
Riverside, CA 92503-7057

Mailing address

12448 Orangeblossom LN
Riverside, CA 92503-7057
Phone (951) 329-0372

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
I20240130003140 CA Order and Referring Only - DentistPractitioner - Dentist 5294188843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1871281634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12448 ORANGEBLOSSOM LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925037057",
            "telephone_number": "951-329-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12448 ORANGEBLOSSOM LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925037057",
            "telephone_number": "951-329-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA",
        "first_name": "CASEY",
        "middle_name": "CHING",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.