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EAGLE GLEN DENTAL GROUP
NPI 1417128034
Dentist - General Practice in Corona, CA

Active since March 24, 2008
3811 BEDFORD CANYON RD STE 105, CORONA, CA 92883(951) 270-0211(951) 270-0702 Get Directions Write a Review

NPPES record last updated: March 24, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Eagle Glen Dental Group NPPES

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

EAGLE GLEN DENTAL GROUP (NPI 1417128034) is a healthcare organization registered as a general practice in Corona, California and active in the NPI registry since March 2008. The organization lists Pauline Pham Wong, President, as its authorized official.

NPPES Registry Identity

NPI1417128034
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameWONG & PHAM DDS, INC.
Location Address3811 BEDFORD CANYON RD STE 105Corona, CA 92883-0789
Mailing AddressPo Box 27250Anaheim, CA 92809-0297 · (951) 270-0211 · Fax (951) 270-0702
Phone(951) 270-0211
Fax(951) 270-0702
Organization SubpartNo
Authorized OfficialPauline Pham WongPresident · (951) 270-0211
Enumeration DateMarch 24, 2008
✔ NPI 1417128034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 53643
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3811 BEDFORD CANYON RD STE 105, Corona, CA 92883
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Other Names 1

Doing Business AsEagle Glen Dental Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PAULINE PHAM WONG DDS
Dentist
3811 BEDFORD CANYON RD STE 105
CORONA, CA 92883
Riverside County (951) 270-0211
DR. STEPHEN CHUNG KIM DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
3811 BEDFORD CANYON RD STE 105
CORONA, CA 92883
Riverside County (951) 270-0211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wong & Pham Dds, Inc.'s NPI number?

The NPI number for Wong & Pham Dds, Inc. is 1417128034. It was assigned to this organization in the NPPES registry on March 24, 2008. The provider is doing business as Eagle Glen Dental Group.

Where is Wong & Pham Dds, Inc. located?

Wong & Pham Dds, Inc. is located at 3811 Bedford Canyon Rd Ste 105, Corona, CA 92883. The listed phone number is (951) 270-0211.

What is Wong & Pham Dds, Inc.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Wong & Pham Dds, Inc. was last updated on March 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.