Individual provider Active NPI

Andrew Chia Yuen Chen, D.D.S.

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1346224946
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
51909 Issued in CA
Practice address
3015 Trap Rock Way
Sacramento, CA 95835-1858
Phone
(916) 837-9694
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 51909 CA Primary

Addresses

Primary practice location

3015 Trap Rock Way
Sacramento, CA 95835-1858

Mailing address

20147 S. Pioneer Blvd
Lakewood, CA 90715-1051
Phone (562) 924-0558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181217003110 CA Order and Referring Only - DentistPractitioner - Dentist 8628395654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51909CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew C. Chen, DDS, Inc. General Practice Past Accepting new patients
Kenny Young Kim DDS Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346224946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20147 S. PIONEER BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907151051",
            "telephone_number": "562-924-0558",
            "fax_number": "562-924-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 TRAP ROCK WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351858",
            "telephone_number": "916-837-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ANDREW",
        "middle_name": "CHIA YUEN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.