NPIMap

Organization Active NPI

Chan Family Dentistry General Partnership

  • Dental Clinic/Center
  • San Lorenzo, CA
National Provider Identifier
1194404673
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CHAN FAMILY DENTISTRY GENERAL PARTNERSHIP
Doing business as
Chan Family Dentistry
Practice address
15522 Hesperian Blvd
San Lorenzo, CA 94580-1609
Phone
(510) 481-1552
Fax
(510) 481-8800
NPI assigned
Jul 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Authorized official

Name
Dr. Carlton David Chan, DDSNPI 1639579477
Title
Partner
Phone
(510) 512-8037

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

15522 Hesperian Blvd
San Lorenzo, CA 94580-1609

Mailing address

15522 Hesperian Blvd
San Lorenzo, CA 94580-1609
Phone (510) 481-1552

Other names 1

  • Chan Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

15522 Hesperian Blvd
Ashland, CA 94580
Phone (510) 481-1552

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1194404673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15522 HESPERIAN BLVD",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945801609",
            "telephone_number": "510-481-1552",
            "fax_number": "510-481-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15522 HESPERIAN BLVD",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945801609",
            "telephone_number": "510-481-1552",
            "fax_number": "510-481-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAN FAMILY DENTISTRY GENERAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "510-512-8037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chan Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Lorenzo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.