Individual provider Active NPI

Jacky Polam Chow, D.M.D., M.SC.

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1346383981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34293 Issued in CA
Practice address
500 Sutter St.,
819
San Francisco, CA 94102-1117
Phone
(415) 391-1060
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 34293 CA Primary

Addresses

Primary practice location

500 Sutter St.,
819
San Francisco, CA 94102-1117

Mailing address

500 Sutter St.,
819
San Francisco, CA 94102-1117
Phone (415) 391-1060

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
34293CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346383981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUTTER ST.,",
            "address_2": "819",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021117",
            "telephone_number": "415-391-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SUTTER ST.,",
            "address_2": "819",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021117",
            "telephone_number": "415-391-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOW",
        "first_name": "JACKY",
        "middle_name": "POLAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.SC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34293",
            "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 Jul 8, 2007; 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.