NPIMap

Organization Active NPI

Polly Chan DDS Inc

  • Dentist
  • Foster City, CA
National Provider Identifier
1508931247
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41166 Issued in CA
Legal business name
POLLY CHAN DDS INC
Practice address
581 Foster City Blvd
Foster City, CA 94404
Phone
(650) 286-9999
Fax
(650) 286-9986
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Polly Chung Pei Chan, DDSNPI 1396124491
Title
Owner
Phone
(650) 286-9999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 41166 CA Primary

Addresses

Primary practice location

581 Foster City Blvd
Foster City, CA 94404

Mailing address

581 Foster City Blvd
Foster City, CA 94404
Phone (650) 286-9999

National Provider Directory

National Provider Directory

Locations

581 Foster City Blvd
Foster City, CA 94404
Phone (650) 286-9999

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508931247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 FOSTER CITY BLVD",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "94404",
            "telephone_number": "650-286-9999",
            "fax_number": "650-286-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 FOSTER CITY BLVD",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "94404",
            "telephone_number": "650-286-9999",
            "fax_number": "650-286-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLLY CHAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "CHUNG PEI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-286-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foster City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.