Ashley Chan, D.D.S
Individual provider Active NPI Dentist · Albany, CA
NPI 1447628516 · NPPES record last updated Sep 8, 2015
Key facts
- NPI
- 1447628516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 64998 (CA)
- Practice address
- 545 Pierce St Apt 1109
Albany, CA 94706-1048 - Phone
- (707) 344-1173
- NPI assigned
- Sep 8, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160321002211 | TX | Order and Referring Only - Dentist |
8921305871 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64998 | CA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64998 | CA | Yes |
Addresses
Primary practice location
545 Pierce St Apt 1109
Albany, CA 94706-1048
Mailing address
545 Pierce St Apt 1109
Albany, CA 94706-1048
Phone (707) 344-1173
Other providers in Albany, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.