Active NPI
Justin Roger Chew, DDS
- Dentist
- Grass Valley, CA
National Provider Identifier
1700512456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS109896
- Practice address
- 300 Sierra College Dr Ste 110
Grass Valley, CA 95945-5083 - Phone
- (916) 790-7597
- NPI assigned
- Jul 26, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901601517 | MI | |
| Dentist | 122300000X | DDS109896 | CA | Primary |
Addresses
Primary practice location
300 Sierra College Dr Ste 110
Grass Valley, CA 95945-5083
Mailing address
9455 Crocker Rd
Granite Bay, CA 95746-6740
Phone (916) 790-7597
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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS109896 | CA | MD | Dentist |
| 2901601517 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1700512456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9455 CROCKER RD",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957466740",
"telephone_number": "916-790-7597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SIERRA COLLEGE DR STE 110",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959455083",
"telephone_number": "916-790-7597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEW",
"first_name": "JUSTIN",
"middle_name": "ROGER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-26",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901601517",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS109896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.