Individual provider Active NPI

Juergen Langenbach, D.M.D., F.A.G.D.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1962420596
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50631 Issued in CA
Practice address
15717 Bernardo Heights Pkwy
San Diego, CA 92128-3155
Phone
(858) 451-4413
Fax
(858) 451-2916
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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 50631 CA Primary

Addresses

Primary practice location

15717 Bernardo Heights Pkwy
San Diego, CA 92128-3155

Mailing address

15717 Bernardo Heights Pkwy
San Diego, CA 92128-3155
Phone (858) 451-3110

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150122002216 CA Order and Referring Only - General PracticePractitioner - General Practice 2163698069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50631CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Juergen Langenbach, DMD, a Professional Dental Corporation Current Accepting new patients
Juergen Langenbach, D.M.D., a.P.D.C. Current Accepting new patients

Locations

15725 Pomerado Rd
Ste 104
Poway, CA 92064
Phone (858) 451-3110

15717 Bernardo Heights Pkwy
San Diego, CA 92128
Phone (858) 451-1908

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1962420596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15717 BERNARDO HEIGHTS PKWY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283155",
            "telephone_number": "858-451-3110",
            "fax_number": "858-451-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15717 BERNARDO HEIGHTS PKWY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283155",
            "telephone_number": "858-451-4413",
            "fax_number": "858-451-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGENBACH",
        "first_name": "JUERGEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D., F.A.G.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.