Individual provider Active NPI

Diana Dang, DMD

  • Dentist
  • Victorville, CA
National Provider Identifier
1881112993
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
101883 Issued in CA
Practice address
13792 Bear Valley Rd # 1
Victorville, CA 92392-8713
Phone
(760) 245-2010
NPI assigned
Sep 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 101883 CA Primary

Addresses

Primary practice location

13792 Bear Valley Rd # 1
Victorville, CA 92392-8713

Mailing address

25590 Prospect Ave Apt 12F
Loma Linda, CA 92354-3145

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
I20171221002176 CA Order and Referring Only - DentistPractitioner - Dentist 0547528481

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": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1881112993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25590 PROSPECT AVE APT 12F",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13792 BEAR VALLEY RD # 1",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923928713",
            "telephone_number": "760-245-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "DIANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.