Active NPI
Connie F Chen, DDS
- Dentist
- Santa Clara, CA
National Provider Identifier
1043680697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64930
- Practice address
- 1042 Homestead Rd
Santa Clara, CA 95050-5402 - Phone
- (408) 557-8338
- NPI assigned
- Sep 25, 2015
- 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 | 64930 | CA | Primary |
Addresses
Primary practice location
1042 Homestead Rd
Santa Clara, CA 95050-5402
Mailing address
1042 Homestead Road
Santa Clara, CA 95050
Phone (408) 807-7998
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160408000771 | CA | Order and Referring Only - Other (Physician) | 6800194788 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1043680697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1042 HOMESTEAD ROAD",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "95050",
"telephone_number": "408-807-7998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1042 HOMESTEAD RD",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950505402",
"telephone_number": "408-557-8338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "CONNIE",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-25",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.