Individual provider Active NPI

Timothy Tang

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1205311834
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103215 Issued in CA
Practice address
1450 Monterey Boulevard
San Francisco, CA 94127
Phone
(415) 598-7610
NPI assigned
Sep 28, 2018
Last updated
Nov 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 103215 CA Primary

Addresses

Primary practice location

1450 Monterey Boulevard
San Francisco, CA 94127

Mailing address

1450 Monterey Blvd
San Francisco, CA 94127-2044

Other practice location 1

1450 Monterey Boulevard
San Francisco, CA 94127
Phone (415) 598-7610

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

LicenseStateTypeSpecialty
103215CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1205311834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 MONTEREY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941272044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MONTEREY BOULEVARD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94127",
            "telephone_number": "415-598-7610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Monterey Boulevard",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94127",
            "country_code": "US",
            "telephone_number": "415-598-7610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANG",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.