MEAD VALLEY COMMUNITY DENTAL CLINIC
NPI 1881021434
Dentist in Perris, CA

NPI Status: Active since September 27, 2013

Contact Information

21091 RIDER ST
SUITE 203
PERRIS, CA
ZIP 92570
Phone: (951) 322-4058

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  • Organization
  • Dentist
  • Accepts Insurance
  • CLIA Number: 05D2075605
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-31-2026

About MEAD VALLEY COMMUNITY DENTAL CLINIC

This page provides the complete NPI Profile along with additional information for Mead Valley Community Dental Clinic, a provider established in Perris, California operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1881021434 assigned on September 2013. The practitioner's primary taxonomy code is 122300000X with license number 46484 (CA). The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Mead Valley Community Dental Clinic. The authorized official of this NPI record is Dr. Oh Jae Kwon Dds (President)

NPI
1881021434
Provider Legal Name
KWON DDS PROFESSIONAL CORPORATION
Other Organization Name
MEAD VALLEY COMMUNITY DENTAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
21091 RIDER ST SUITE 203 PERRIS, CA 92570
Location Phone
(951) 322-4058
Mailing Address
21091 RIDER ST SUITE 203 PERRIS, CA 92570
Mailing Phone
(951) 322-4058
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
09-27-2013
Last Update Date
02-10-2017
Code Navigator

A dentist like Mead Valley Community Dental Clinic is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist

Taxonomy Code
122300000X
Type
Dental Providers
License No.
46484
License State
CA
Taxonomy Description
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.

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Lone Star - Smile Now - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. OH JAE KWON DDS

Authorized Official Title
PRESIDENT
Authorized Official Phone
(951) 322-4058

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
05D2075605
Facility Type
Physician Office
Certificate Effective Date
April 01, 2024
Certificate Expiration Date
March 31, 2026
Laboratory Director
JAVIER R. RIOS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mead Valley Community Dental Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1881021434, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
1
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
1
Doubled → 2
Pos 8
4
Unchanged
Pos 9
3
Doubled → 6
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 0 → 0 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 6 + 1 + 0 + 2 + 2 + 4 + 6 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1881021434.

Other Providers at the Same Location


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

Family Medicine
21091 RIDER ST, STE 218
PERRIS, CA 92570

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881021434, enumerated as an "organization" on September 27, 2013.

The provider is located at 21091 RIDER ST SUITE 203 PERRIS, CA 92570 and the phone number is (951) 322-4058.

Dentist with taxonomy code 122300000X.

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