Individual provider Active NPI

Ellaine Saavedra Chen, D.D.S.

  • General Practice Dentistry
  • City of Industry, CA
National Provider Identifier
1568684108
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48367 Issued in CA
Practice address
17980 Castleton St Ste 2
City of Industry, CA 91748-1850
Phone
(626) 388-4457
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 48367 CA Primary

Addresses

Primary practice location

17980 Castleton St Ste 2
City of Industry, CA 91748-1850

Mailing address

3845 Sycamore St
West Covina, CA 91792-2763
Phone (626) 388-4457

Other names 1

  • Dr. Ellaine Bucoy Saavedra Former name

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
48367CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ellaine S. Chen, D.D.S., Inc General Practice Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568684108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 SYCAMORE ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922763",
            "telephone_number": "626-388-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17980 CASTLETON ST STE 2",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481850",
            "telephone_number": "626-388-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ELLAINE",
        "middle_name": "SAAVEDRA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLAINE",
            "last_name": "SAAVEDRA",
            "middle_name": "BUCOY",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in City of Industry, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.