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RANCHO CORDOVA DENTAL GROUP
NPI 1508994922
Dentist - General Practice in Rancho Cordova, CA

Active since February 28, 2007CLIA 05D2338971 · Waiver
10910 OLSON DR, STE 100, RANCHO CORDOVA, CA 95670(916) 638-3780(916) 638-1062 Get Directions Write a Review

NPPES record last updated: April 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rancho Cordova Dental Group NPPES

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

RANCHO CORDOVA DENTAL GROUP (NPI 1508994922) is a healthcare organization registered as a general practice in Rancho Cordova, California and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through February 19, 2028 and lists Dong J Jeong, Owner Doctor, as its authorized official.

NPPES Registry Identity

NPI1508994922
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameJEONG DENTAL CORPORATION
Location Address10910 OLSON DR, STE 100Rancho Cordova, CA 95670-5643
Mailing Address17000 Red Hill AveIrvine, CA 92614-5626 · (714) 508-3600 · Fax (714) 368-2092
Phone(916) 638-3780
Fax(916) 638-1062
Organization SubpartNo
Authorized OfficialDong J JeongOwner Doctor · (916) 638-3780
Enumeration DateFebruary 28, 2007
Last NPPES UpdateApril 21, 2021
NPPES CertifiedApril 21, 2021
✔ NPI 1508994922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
10910 OLSON DR, Rancho Cordova, CA 95670
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Other Names 1

Doing Business AsRancho Cordova 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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2338971

Rancho Cordova Dental Group · Rancho Cordova, CA
Active · expires Feb 19, 2028
CLIA Number05D2338971
Laboratory TypeDental Practice
Certificate Effective DateFebruary 20, 2026
Certificate Expiration DateFebruary 19, 2028
Laboratory DirectorDong J. Jeong
Laboratory Phone(916) 638-3780
Laboratory LocationRancho Cordova Dental Group10910 Olson Dr Ste 100, Rancho Cordova, CA 95670
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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. BRENDA L BOYTE DDS
Dentist (General Practice)
10910 OLSON DR, STE. 100
RANCHO CORDOVA, CA 95670
Sacramento County (916) 638-3780
DR. YUN HWAN OH D.D.S.
Dentist
10910 OLSON DR, STE 100
RANCHO CORDOVA, CA 95670
Sacramento County (916) 638-3780

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 Jeong Dental Corporation's NPI number?

The NPI number for Jeong Dental Corporation is 1508994922. It was assigned to this organization in the NPPES registry on February 28, 2007. The provider is doing business as Rancho Cordova Dental Group.

Where is Jeong Dental Corporation located?

Jeong Dental Corporation is located at 10910 Olson Dr Ste 100, Rancho Cordova, CA 95670. The listed phone number is (916) 638-3780.

What is Jeong Dental Corporation's specialty?

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

Does Jeong Dental Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2338971) is associated with this NPI, valid through February 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jeong Dental Corporation was last updated on April 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.