Individual provider Active NPI

Aaron Christopher Pobre Tan, DDS

  • Dentist
  • Dinuba, CA
National Provider Identifier
1689401903
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110788 Issued in CA
Practice address
2108 E El Monte Way
Dinuba, CA 93618-9375
Phone
(559) 591-4600
Fax
(559) 591-4800
NPI assigned
Sep 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 110788 CA Primary

Addresses

Primary practice location

2108 E El Monte Way
Dinuba, CA 93618-9375

Mailing address

2108 E El Monte Way
Dinuba, CA 93618-9375
Phone (559) 591-4600

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
110788CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jose Ricardo Gonzalez, D.D.S. a Dental Corporation PastSince Sep 23, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1689401903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E EL MONTE WAY",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936189375",
            "telephone_number": "559-591-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 E EL MONTE WAY",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936189375",
            "telephone_number": "559-591-4600",
            "fax_number": "559-591-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "AARON CHRISTOPHER",
        "middle_name": "POBRE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "110788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dinuba, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.