DR. OTIS T CHONG (NPI# 1861663148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861663148 |
| Entity Type | Individual |
| Full Name | DR. OTIS T CHONG |
| Credential | DMD |
| Practice Address |
30190 Town Center Drive Suite B Laguna Niguel CA 92677 |
| Practice Telephone | 9493632540 |
| Practice Fax Number | 9493633352 |
| Mailing Telephone | 9493632540 |
| Mailing Fax Number | 9493633352 |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2017-01-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 215521 | MA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
56385 | CA | Dental Providers |
| Street Address |
30190 TOWN CENTER DRIVE SUITE B |
| City | LAGUNA NIGUEL |
| State | CA |
| Zip Code | 92677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174592372 | Trent Howard Westernoff | Dentist | 30190 Town Center Drive, Suite B, Laguna Niguel, CA 92677 | 2006-03-17 |
| 1487831871 | Peter T Kimball | Dentist | 30190 Town Center Drive, Suite A, Laguna Niguel, CA 92677 | 2008-01-28 |
| 1124241583 | Joseph Humphrey Anderson | Dentist | 30190 Town Center Drive, Suite B, Laguna Niguel, CA 92677 | 2007-04-11 |
| 1588786271 | Michael Luan Phuong Nguyen | Dentist | 30190 Town Center Drive, Suite B, Laguna Niguel, CA 92677 | 2007-04-04 |
| 1689796377 | James Earl Pastor | Dentist | 30190 Town Center Drive, Suite B, Laguna Niguel, CA 92677 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114566049 | Amber Kramer | Physical Therapist | 30100 Town Center Drive #yz, Laguna Niguel, CA 92677 | 2019-12-23 |
| 1811548340 | Morgan Peikar | Rehabilitation Hospital | 28441 Springfield Dr, Laguna Niguel, CA 92677 | 2019-09-25 |
| 1871056382 | Jacqueline Evamarie Serrano | Chiropractor | 28062 Forbes Road, Laguna Niguel, CA 92677 | 2019-04-11 |
| 1316408859 | Azadeh Ghafari | Social Worker | 30100 Town Center Dr # 179, Laguna Niguel, CA 92677 | 2019-03-27 |
| 1346741857 | Diana Wang | Physical Medicine & Rehabilitation | 30100 Town Center Drive Suite, Suite Yz, Laguna Niguel, CA 92677 | 2018-02-21 |
| 1750833554 | James H. Tran Dds, Dental Corp. | Dentist | 23876 Aliso Creek Road, Laguna Niguel, CA 92677 | 2016-10-27 |
| 1215486139 | Kevin Sun | Dentist | 49 Blue Horizon, Laguna Niguel, CA 92677 | 2016-10-04 |
| 1740637842 | Michael Dacosta | Dentist | 28862 Calle Vista, Laguna Niguel, CA 92677 | 2016-05-18 |
| 1235590373 | Adrian Gomez | Counselor | 24361 Nugget Falls Ln, Laguna Niguel, CA 92677 | 2016-03-17 |
| 1427455906 | Gracie Heart Home Health LLC | Home Health | 24318 El Pilar, Laguna Niguel, CA 92677 | 2014-11-26 |
| Find all providers in zip 92677 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578655 | Pinole Endodontics | Dentist | 2150 Appian Way Ste 207, Pinole, CA 94564-2520 | 2020-11-05 |
| 1518566702 | Sp Endodontics Partnershiop | Dentist | 1300 W Lodi Ave Ste N, Lodi, CA 95242-3038 | 2020-10-20 |
| 1215535661 | Ascella Justine Ronson | Dentist | 35395 Linda Rosea Rd, Temecula, CA 92592-9532 | 2020-10-16 |
| 1457964215 | Lars Bjorn Jonsson, D.d.s., M.s., Inc. | Dentist | 25261 Paseo De Valencia Ste 3, Laguna Hills, CA 92637-4966 | 2020-08-31 |
| 1952929333 | Noureldin Shoreibah Dds Inc | Dentist | 7677 Center Ave Ste 210, Huntington Beach, CA 92647-9103 | 2020-07-11 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1568091833 | M. Potti Dds Msd Inc | Dentist | 6400 Village Pkwy Ste 100, Dublin, CA 94568-3007 | 2020-04-07 |
| 1194356840 | Liang Dental Group Inc | Dentist | 5562 Philadelphia St Ste 211, Chino, CA 91710-2499 | 2020-01-31 |
| 1699313015 | Paul Erben Dmd Msd PC | Dentist | 937 E Main St Ste 204, Santa Maria, CA 93454-5309 | 2019-12-16 |
| 1396382495 | Narbeh Bandary Dental Corp | Dentist | 4910 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1718 | 2019-12-08 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA NIGUEL |
| Zip Code | 92677 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.