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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. PRASONG IAMSUREY D.D.S.
NPI 1619910767
Dentist - General Practice in Kelseyville, CA

Active since June 14, 2006PECOS Enrolled
4150 MAIN ST, KELSEYVILLE, CA 95451(707) 279-4251(707) 279-8335 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Prasong Iamsurey D.d.s. NPPES

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

DR. PRASONG IAMSUREY D.D.S. (NPI 1619910767) is an individual general practice provider in Kelseyville, California, licensed in California (34119) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619910767
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. PRASONG IAMSUREYCredential: D.D.S.
Location Address4150 MAIN STKelseyville, CA 95451-9402
Mailing Address4150 Main Street, Po Box 514Kelseyville, CA 95451-0514 · (707) 279-4251 · Fax (707) 279-8335
Phone(707) 279-4251
Fax(707) 279-8335
Sole ProprietorNo
Enumeration DateJune 14, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1619910767 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 · 34119
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.
4150 MAIN ST, Kelseyville, CA 95451
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Prasong Iamsurey D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95451 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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

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

DR. JAMES PRASERT IAMSUREY D.D.S.
Dentist (General Practice)
4150 MAIN ST
KELSEYVILLE, CA 95451
Lake County (707) 279-4251

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 Prasong Iamsurey's NPI number?

The NPI number for Prasong Iamsurey is 1619910767. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Where is Prasong Iamsurey located?

Prasong Iamsurey practices at 4150 Main St, Kelseyville, CA 95451. The listed phone number is (707) 279-4251.

What is Prasong Iamsurey's specialty?

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

Is Prasong Iamsurey enrolled in Medicare?

Yes. Prasong Iamsurey is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Prasong Iamsurey was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.