Bahareh Fatemi, DMD

Individual provider Active NPI General Practice Dentistry · Foster City, CA

NPI 1245081835 · NPPES record last updated Apr 1, 2024

Key facts

NPI
1245081835
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DDS108272 (CA)
Practice address
581 Foster City Blvd
Foster City, CA 94404-1695
Phone
(650) 286-9999
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DDS108272CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Polly Chan DDS Inc Single Specialty Past
since Apr 9, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X DDS108272 CA Yes

Addresses

Primary practice location

581 Foster City Blvd
Foster City, CA 94404-1695

Mailing address

722 Edgewater Blvd Apt 301
Foster City, CA 94404-2843
Phone (415) 696-8444

Other providers in Foster City, CA

All providers in Foster City, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.