Priyashna Prishika Chand, BDS
Individual provider Active NPI Dentist · Pago Pago, AS
NPI 1083475339 · NPPES record last updated Jan 23, 2024
Key facts
- NPI
- 1083475339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5096C (AS)
- Practice address
- 1 Paul Turner Drive
Pago Pago, AS 96799-0010 - Phone
- (684) 633-1222
- Fax
- (684) 633-1839
- NPI assigned
- Jan 23, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240416002226 | AS | Practitioner - Dentist | 5092154625 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5096C | AS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Samoa Medical Center | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5096C | AS | Yes |
Addresses
Primary practice location
1 Paul Turner Drive
Pago Pago, AS 96799-0010
Mailing address
PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222
Other providers in Pago Pago, AS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.