Carolyn Ong Tan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59201 Issued in CA

Practice address

828 S Mooney Blvd
Visalia, CA 93277-2212

Phone

(559) 802-4300

NPI assigned

Dec 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Carolyn R Ong Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carolyn.tan.p1@direct.altura.nextgenshare.com
• Direct secure messaging: carolyn.tan.1@17661.direct.athenahealth.com

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

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)
• United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Huron, CA
  • NPI 1134101686
  NPD (past)

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487462400000",
    "number": "1902340847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932772212",
            "telephone_number": "559-802-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932772212",
            "telephone_number": "559-802-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "CAROLYN",
        "middle_name": "ONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2017-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "ONG",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Julia Talley, M.D.
• Roger Aying Talob Jr., MPAS, PA-C
• Martha P Tamayo-Campos
• Jose Manuel Tamez, LMFT
• Briana Tan, PA-C
• Julia Tan, MD
• Rae Angela Tan, R.N.
• Timothy Lang Tan, M.D.
• Seng Leang Tang-Hignojoz, LMFT
• Michael Tang, MD

• General Practice Dentistry in Visalia, CA
• Providers in Visalia, 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 Feb 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.