JACK PAI DDS
NPI 1447778220
Dentist in Rancho Cucamonga, CA

Q: What is Jack Pai's NPI number?

The NPI number for Jack Pai is 1447778220. It was assigned to this individual provider in the NPPES registry on August 31, 2017.

Q: What is Jack Pai's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Pai was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 31, 2017PECOS Enrolled

10470 FOOTHILL BLVD # 250, RANCHO CUCAMONGA, CA 91730(626) 757-9906(909) 984-3463 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 20, 2024, Mar 17, 2021, Aug 31, 2017 (3 updates tracked since 2017).

On this page

About Jack Pai Dds NPPES

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

JACK PAI DDS (NPI 1447778220) is an individual dentist in Rancho Cucamonga, California, licensed in California (DDS101787) and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS and is a graduate of Univ Of The Pacific Dugoni School Of Dentistry (2017).

NPPES Registry Identity

NPI1447778220

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameJACK PAICredential: DDS

Location Address10470 FOOTHILL BLVD # 250Rancho Cucamonga, CA 91730-3754

Mailing Address179 Rex CirCampbell, CA 95008-1011 · (626) 757-9906

Phone(626) 757-9906

Fax(909) 984-3463

Sole ProprietorNo

Medical School CMSUniv Of The Pacific Dugoni School Of DentistryGraduated 2017

Enumeration DateAugust 31, 2017

Last NPPES UpdateJune 20, 20243 updates tracked since enumeration

NPPES CertifiedJune 20, 2024

✔ NPI 1447778220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · DDS101787

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

10470 FOOTHILL BLVD # 250, Rancho Cucamonga, CA 91730

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Pai Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608132055

PECOS Enrollment IDI20260224003148

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jack Pai reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wonderful Life Dental Group

Same address

Dental

10470 FOOTHILL BLVD # 250
Rancho Cucamonga, CA 91730

Reassigned Medicare billing, California enrollment

NPI 1801623871 (626) 757-9906

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91730 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

WONDERFUL LIFE DENTAL GROUP

Clinic/Center (Dental)

10470 FOOTHILL BLVD # 250
RANCHO CUCAMONGA, CA 91730

San Bernardino County (626) 757-9906

DR JACK PAI DDS INC

Clinic/Center (Dental)

10470 FOOTHILL BLVD # 250
RANCHO CUCAMONGA, CA 91730

San Bernardino County (626) 757-9906

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 Jack Pai's NPI number?

The NPI number for Jack Pai is 1447778220. It was assigned to this individual provider in the NPPES registry on August 31, 2017.

Where is Jack Pai located?

Jack Pai practices at 10470 Foothill Blvd # 250, Rancho Cucamonga, CA 91730. The listed phone number is (626) 757-9906.

What is Jack Pai's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jack Pai enrolled in Medicare?

Yes. Jack Pai is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jack Pai's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Pai reassigns Medicare benefits to Wonderful Life Dental Group (Rancho Cucamonga, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Pai's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jack Pai accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 4 other insurers list Jack Pai as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Pai was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.