Individual provider Active NPI

Roland G. Chew, D.D.S.

  • General Practice Dentistry
  • Fremont, CA
National Provider Identifier
1780745000
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41169 Issued in CA
Practice address
39055 Hastings St
Suite 203
Fremont, CA 94538-1518
Phone
(510) 793-0300
Fax
(510) 793-0301
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

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 41169 CA Primary

Addresses

Primary practice location

39055 Hastings St
Suite 203
Fremont, CA 94538-1518

Mailing address

39055 Hastings St
Suite 203
Fremont, CA 94538-1518
Phone (510) 793-0300

Other identifiers 1

IdentifierTypeStateIssuer
41169OtherCASTATE LICENSE

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
41169CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780745000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39055 HASTINGS ST",
            "address_2": "SUITE 203",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381518",
            "telephone_number": "510-793-0300",
            "fax_number": "510-793-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39055 HASTINGS ST",
            "address_2": "SUITE 203",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381518",
            "telephone_number": "510-793-0300",
            "fax_number": "510-793-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEW",
        "first_name": "ROLAND",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "41169",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, 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.