Organization Active NPI

Ngoc Lan Vo D.D.S. Inc.

  • General Practice Dentistry
  • Arcadia, CA
National Provider Identifier
1891001566
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NGOC LAN VO D.D.S. INC.
Doing business as
21 Dental Group
Practice address
21 W Duarte Rd Ste a
Arcadia, CA 91007-6969
Phone
(626) 821-9970
Fax
(626) 821-0996
NPI assigned
Aug 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Dr. Ngoc Lan VoNPI 1679706766
Title
President
Phone
(626) 821-9970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

21 W Duarte Rd Ste a
Arcadia, CA 91007-6969

Mailing address

21 W Duarte Rd Ste a
Arcadia, CA 91007-6969
Phone (626) 821-9970

Other names 1

  • 21 Dental Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180424002353 CA Part B Supplier - Clinic/Group Practice 6800159963 Receives reassigned benefits from 1 practitioner
Practice locations: Arcadia, CA
O20181029000286 CA DME Supplier - Oral Surgery - Dentist 6800159963 Practice locations: Arcadia, CA

National Provider Directory

National Provider Directory

Locations

21 W Duarte Rd
Arcadia, CA 91007
Phone (626) 821-9970

21 W Duarte Rd
Ste A
Arcadia, CA 91007
Phone (626) 821-9970

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1891001566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W DUARTE RD STE A",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076969",
            "telephone_number": "626-821-9970",
            "fax_number": "626-821-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W DUARTE RD STE A",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076969",
            "telephone_number": "626-821-9970",
            "fax_number": "626-821-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGOC LAN VO D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "NGOC LAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-821-9970",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "21 Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.