Individual provider Active NPI

Karen Chong

  • Dentist
  • Pleasanton, CA
National Provider Identifier
1427607910
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS104274 Issued in CA
Practice address
2709 Stoneridge Dr Ste 103
Pleasanton, CA 94588-8349
Phone
(925) 523-3345
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS104274 CA Primary

Addresses

Primary practice location

2709 Stoneridge Dr Ste 103
Pleasanton, CA 94588-8349

Mailing address

2709 Stoneridge Dr Ste 103
Pleasanton, CA 94588-8349
Phone (925) 523-3345

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200421000614 CA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 0345670030 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS104274CAMDDentist
104274CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Mar 26, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 26, 2020 Accepting new patients
University of California San Francisco CurrentSince Mar 26, 2020 Accepting new patients
UCSF Oral & Maxillofacial Surgery CurrentSince Mar 26, 2020 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 26, 2020 Accepting new patients

Locations

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

513 Parnassus Ave
Rm S722
San Francisco, CA 94143
Phone (415) 476-2045

513 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-1239

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

Organizations & group practices 6

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": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1427607910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 STONERIDGE DR STE 103",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888349",
            "telephone_number": "925-523-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 STONERIDGE DR STE 103",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888349",
            "telephone_number": "925-523-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "KAREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.