Healthcare Provider Details

I. General information

NPI: 1346192549
Provider Name (Legal Business Name): LORAN ONG DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 HARRIS ST
EUREKA CA
95503-4448
US

IV. Provider business mailing address

604 HARRIS ST
EUREKA CA
95503-4448
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-8064
  • Fax: 707-443-0344
Mailing address:
  • Phone: 707-443-8064
  • Fax: 707-443-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: LORAN EDWARD ONG
Title or Position: CEO
Credential: DDS
Phone: 909-913-7895