Individual provider Active NPI

Robert K Cheng, D.D.S.

  • General Practice Dentistry
  • Roseville, CA
National Provider Identifier
1902139298
Registry record updated Dec 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58647 Issued in CA
Practice address
2370 Professional Dr
Roseville, CA 95661-7745
Phone
(916) 782-1033
NPI assigned
Sep 17, 2009
Last updated
Dec 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58647 CA Primary

Addresses

Primary practice location

2370 Professional Dr
Roseville, CA 95661-7745

Mailing address

2370 Professional Dr
Roseville, CA 95661-7745

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
I20161215001553 CA Order and Referring Only - DentistPractitioner - Dentist 8426338112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58647CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Cheng Dental Corpoation, Inc. CurrentSince Oct 5, 2021 Accepting new patients

Locations

2370 Professional Dr
Roseville, CA 95661
Phone (916) 782-1033

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480809600000",
    "number": "1902139298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 PROFESSIONAL DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 PROFESSIONAL DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617745",
            "telephone_number": "916-782-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-17",
        "last_updated": "2016-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.