Individual provider Active NPI

Peggy Xin Xin Chen

  • Dentist
  • Honolulu, HI
National Provider Identifier
1366076978
Registry record updated Jul 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT-2919 Issued in HI
Practice address
1601 Kapiolani Blvd Ste 101
Honolulu, HI 96814-4750
Phone
(808) 941-5555
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT-2919 HI Primary

Addresses

Primary practice location

1601 Kapiolani Blvd Ste 101
Honolulu, HI 96814-4750

Mailing address

2609 Ala Wai Blvd Apt 1104
Honolulu, HI 96815-3905

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
DT-2919HIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ala Moana Dental Care, Inc. PastSince Aug 8, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627689600000",
    "number": "1366076978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 ALA WAI BLVD APT 1104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968153905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KAPIOLANI BLVD STE 101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144750",
            "telephone_number": "808-941-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "PEGGY",
        "middle_name": "XIN XIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2021-07-31",
        "certification_date": "2021-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-2919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2021; 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.