POMONA VALLEY DENTAL PRACTICE
NPI 1104023647
Preferred Provider Organization in Pomona, CA

Active since June 28, 2007CLIA 05D0564307 · Accreditation
1290 N GAREY AVE, POMONA, CA 91767(909) 623-1564(909) 629-9126 Get Directions Write a Review

NPPES record last updated: November 13, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pomona Valley Dental Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

POMONA VALLEY DENTAL PRACTICE (NPI 1104023647) is a healthcare organization registered as a preferred provider organization in Pomona, California and active in the NPI registry since June 2007. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Anthony Dung Nguyen, President, as its authorized official.Information from the official NPPES registry record, last updated November 13, 2007.

NPPES Registry Identity

NPI1104023647
Entity TypeOrganization
Legal Business NameANTHONY D. NGUYEN, DDS, INC
Location Address1290 N GAREY AVEPomona, CA 91767-3806
Mailing Address1290 N Garey AvePomona, CA 91767-3806 · (909) 623-1564 · Fax (909) 629-9126
Fax(909) 629-9126
Organization SubpartNo
Authorized OfficialAnthony Dung NguyenPresident · (909) 623-1564
Enumeration DateJune 28, 2007
Last NPPES UpdateNovember 13, 2007
NPI 1104023647 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

Primary Specialty

Preferred Provider Organization

Taxonomy 305R00000X · Managed Care Organizations

Licensed in CA · 47971

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice,… Show more

1290 N GAREY AVE, Pomona, CA 91767

Also on File with NPPES

Other Names1
Pomona Valley Dental Practice (Doing Business As)
Other Identifiers1
B4797101 (Medicaid, CA)

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0564307
Facility Type
Hospital
Certificate Effective Date
January 03, 2025
Certificate Expiration Date
January 02, 2027
Laboratory Director
PHILIP O. STRASSLE
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Pomona Valley Dental Practice on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

Reviews for POMONA VALLEY DENTAL PRACTICE

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Dentist (General Practice)
1290 N GAREY AVE
POMONA, CA 91767

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104023647, enumerated as an "organization" on June 28, 2007.

The provider is located at 1290 N GAREY AVE POMONA, CA 91767 and the phone number is (909) 623-1564.

Preferred Provider Organization with taxonomy code 305R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.