Individual provider Active NPI

Yvette C Chua, D.D.S

  • General Practice Dentistry
  • San Mateo, CA
National Provider Identifier
1699797126
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47603 Issued in CA
Practice address
635 Mariners Island Blvd
Suite 201
San Mateo, CA 94404-1044
Phone
(650) 638-9800
Fax
(650) 638-9802
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

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 47603 CA Primary

Addresses

Primary practice location

635 Mariners Island Blvd
Suite 201
San Mateo, CA 94404-1044

Mailing address

635 Mariners Island Blvd
Suite 201
San Mateo, CA 94404-1044
Phone (650) 638-9800

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
47603CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699797126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MARINERS ISLAND BLVD",
            "address_2": "SUITE 201",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944041044",
            "telephone_number": "650-638-9800",
            "fax_number": "650-638-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MARINERS ISLAND BLVD",
            "address_2": "SUITE 201",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944041044",
            "telephone_number": "650-638-9800",
            "fax_number": "650-638-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "YVETTE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, 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.