Active NPI
Alice Chan, D.D.S.
- Dentist
- Sacramento, CA
National Provider Identifier
1013329598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62987
- Practice address
- 4690 Natomas Blvd
Suite 100
Sacramento, CA 95835-2230 - Phone
- (916) 515-4500
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62987 | CA | Primary |
Addresses
Primary practice location
4690 Natomas Blvd
Suite 100
Sacramento, CA 95835-2230
Mailing address
88 Portola Ave
Daly City, CA 94015-4232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62987 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoang and Rho Dental Corporation | Past | Accepting new patients |
Interoperability endpoints
- achan622010@hisp.ehr.sutterhealth.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Sacramento, CA
- NPI 1326133190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1013329598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 PORTOLA AVE",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940154232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4690 NATOMAS BLVD",
"address_2": "SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958352230",
"telephone_number": "916-515-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ALICE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.