Kelley Nguyen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100565 Issued in CA

Practice address

581 Foster City Blvd
Foster City, CA 94404-1695

Phone

(650) 286-9999

NPI assigned

Jan 28, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 17, 2017 through Feb 17, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Polly Chan DDS Inc

  • Dentist
  • Foster City, CA
  • NPI 1508931247

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1104283613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 HEMLOCK AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013540",
            "telephone_number": "408-646-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 FOSTER CITY BLVD",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041695",
            "telephone_number": "650-286-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1807 Bay Rd",
            "address_purpose": "LOCATION",
            "city": "East Palo Alto",
            "state": "CA",
            "postal_code": "943031312",
            "country_code": "US",
            "telephone_number": "650-289-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Natoli, PPS, MS
• Alfred Ngaw, PHARM.D.
• Regina Tran Ngo, D.M.D.
• Amy Nguyen, M. ED, APCC
• Elena Y Nguyen, MD
• Laemsing Nguyen, PHARM.D
• Jerome Nillo, RPT
• Njoy Medical of Ca PC
• Njoy Medical of NJ PC
• Njoy Medical PA

• General Practice Dentistry in Foster City, CA
• Providers in Foster City, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.