Organization Active NPI

H Sam Tong DDS PHD Inc, a Professional Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Riverside, CA
National Provider Identifier
1992082333
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
45037 Issued in CA
Legal business name
H SAM TONG DDS PHD INC, A PROFESSIONAL CORPORATION
Practice address
11705 Slate Ave Ste 150
Riverside, CA 92505-7119
Phone
(951) 689-8021
Fax
(951) 689-8025
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Authorized official

Name
Hong Lin
Title
General Manager
Phone
(714) 932-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 45037 CA Primary

Addresses

Primary practice location

11705 Slate Ave Ste 150
Riverside, CA 92505-7119

Mailing address

20360 Via Manresa
Yorba Linda, CA 92887-3209
Phone (714) 779-1392

National Provider Directory

National Provider Directory

Locations

11705 Slate Ave
Ste 150
Riverside, CA 92505
Phone (951) 689-8021

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": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1992082333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20360 VIA MANRESA",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928873209",
            "telephone_number": "714-779-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 SLATE AVE STE 150",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925057119",
            "telephone_number": "951-689-8021",
            "fax_number": "951-689-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H SAM TONG DDS PHD INC, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "HONG",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "714-932-9355"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "45037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.