Individual provider Active NPI

Tabitha N Chen, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1912285909
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60584 Issued in CA
Practice address
10520 National Blvd Apt 107
Los Angeles, CA 90034-3670
Phone
(925) 457-7801
NPI assigned
Jul 26, 2011
Last updated
Jul 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60584 CA Primary

Addresses

Primary practice location

10520 National Blvd Apt 107
Los Angeles, CA 90034-3670

Mailing address

10520 National Blvd Apt 107
Los Angeles, CA 90034-3670
Phone (925) 457-7801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717002781 CA Order and Referring Only - DentistPractitioner - Dentist 3678886777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60584CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1912285909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 NATIONAL BLVD APT 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343670",
            "telephone_number": "925-457-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 NATIONAL BLVD APT 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343670",
            "telephone_number": "925-457-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "TABITHA",
        "middle_name": "N",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.