Individual provider Active NPI

Jean Chu, D.D.S.

  • General Practice Dentistry
  • South San Francisco, CA
National Provider Identifier
1689636839
Registry record updated Apr 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30636 Issued in CA
Practice address
144 Brentwood Dr
South San Francisco, CA 94080-5717
Phone
(650) 589-8988
Fax
(650) 351-7721
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2015

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 30636 CA Primary

Addresses

Primary practice location

144 Brentwood Dr
South San Francisco, CA 94080-5717

Mailing address

144 Brentwood Dr
South San Francisco, CA 94080-5717
Phone (650) 589-8988

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
30636CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429315200000",
    "number": "1689636839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BRENTWOOD DR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805717",
            "telephone_number": "650-589-8988",
            "fax_number": "650-351-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 BRENTWOOD DR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805717",
            "telephone_number": "650-589-8988",
            "fax_number": "650-351-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2015-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2015; 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.