NPIMap

Organization Active NPI

The Peterson-Chan Dental Group

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1225274764
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THE PETERSON-CHAN DENTAL GROUP
Practice address
5277 College Ave #203
Oakland, CA 94618-1437
Phone
(510) 654-2226
Fax
(510) 595-1455
NPI assigned
Jan 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Dr. Melinda Jean Chan, DDSNPI 1346383007
Title
Owner
Phone
(510) 654-2226

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5277 College Ave #203
Oakland, CA 94618-1437

Mailing address

5277 College Ave #203
Oakland, CA 94618-1437
Phone (510) 654-2226

National Provider Directory

National Provider Directory

Locations

5277 College Ave
Ste 203
Oakland, CA 94618
Phone (510) 654-2226

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": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1225274764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5277 COLLEGE AVE #203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181437",
            "telephone_number": "510-654-2226",
            "fax_number": "510-595-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5277 COLLEGE AVE #203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181437",
            "telephone_number": "510-654-2226",
            "fax_number": "510-595-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PETERSON-CHAN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-654-2226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.