Active NPI
Fong Yan Diana Chan, D.D.S.
- General Practice Dentistry
- San Francisco, CA
National Provider Identifier
1730469883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60615
- Practice address
- 771 Sacramento St
San Francisco, CA 94108-2504 - Phone
- (415) 362-3388
- NPI assigned
- Aug 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60615 | CA | Primary |
Addresses
Primary practice location
771 Sacramento St
San Francisco, CA 94108-2504
Mailing address
771 Sacramento St
San Francisco, CA 94108-2504
Phone (415) 362-3388
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 |
|---|---|---|---|
| 60615 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1730469883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 SACRAMENTO ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941082504",
"telephone_number": "415-362-3388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 SACRAMENTO ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941082504",
"telephone_number": "415-362-3388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "FONG YAN",
"middle_name": "DIANA",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-22",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "60615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.