Active NPI
Mary Pan, DDS
- General Practice Dentistry
- Dublin, CA
National Provider Identifier
1528124583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46667
- Practice address
- 7000 Village Pkwy
Suite B
Dublin, CA 94568-2454 - Phone
- (925) 828-6746
- Fax
- (925) 828-2389
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46667 | CA | Primary |
Addresses
Primary practice location
7000 Village Pkwy
Suite B
Dublin, CA 94568-2454
Mailing address
7000 Village Pkwy
Suite B
Dublin, CA 94568-2454
Phone (925) 828-6746
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160304001535 | CA | Order and Referring Only - Oral Surgery | 5193021954 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528124583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7000 VILLAGE PKWY",
"address_2": "SUITE B",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682454",
"telephone_number": "925-828-6746",
"fax_number": "925-828-2389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 VILLAGE PKWY",
"address_2": "SUITE B",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682454",
"telephone_number": "925-828-6746",
"fax_number": "925-828-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "MARY",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.