POLLY CHUNG-PEI CHAN D.D.S.
NPI 1396124491
Dentist in Foster City, CA
NPI Status: Active since May 21, 2015
Contact Information
581 FOSTER CITY BLVD
FOSTER CITY, CA
ZIP 94404
Phone: (650) 286-9999
Fax: (650) 286-9986
- Individual
- Female
- Dentist
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About POLLY CHAN
This page provides the complete NPI Profile along with additional information for Polly Chan, a provider established in Foster City, California with a medical specialization in Dentist. The healthcare provider is registered in the NPI registry with number 1396124491 assigned on May 2015. The practitioner's primary taxonomy code is 122300000X with license number 41166 (CA). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1396124491
- Provider Name
- POLLY CHUNG-PEI CHAN D.D.S.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 581 FOSTER CITY BLVD FOSTER CITY, CA 94404
- Location Phone
- (650) 286-9999
- Location Fax
- (650) 286-9986
- Mailing Address
- 581 FOSTER CITY BLVD FOSTER CITY, CA 94404
- Mailing Phone
- (650) 286-9999
- Mailing Fax
- (650) 286-9986
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-21-2015
- Last Update Date
- 05-21-2015
- Code Navigator
A dentist like Polly Chan is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Polly Chan opted out of Medicare effective on 09-15-2015 until 09-15-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist
- Taxonomy Code
- 122300000X
- Type
- Dental Providers
- License No.
- 41166
- License State
- CA
- Taxonomy Description
- A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
- Alabama Preferred Plan - PPO
- Alabama Preferred Plan (Pediatric Only) - PPO
- Alabama Preferred Plus Plan - PPO
- Alabama Preferred Plus Plan (Pediatric Only) - PPO
- Alabama Wellness Essentials Plan - PPO
- Florida Preferred Plan - PPO
- Florida Preferred Plan (Pediatric Only) - PPO
- Florida Preferred Plus Plan - PPO
- Florida Preferred Plus Plan (Pediatric Only) - PPO
- Florida Wellness Essentials Plan - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Polly Chan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-15-2015
Opt-Out End Date: 09-15-2025
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 94404 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $104.51
- Minimum New Patient Price $69
- Maximum New Patient Price $202.35
- Average New Patient Copayment $26.12
- Minimum New Patient Copayment $17.25
- Maximum New Patient Copayment $50.58
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $84.91
- Minimum Established Patient Price $23.44
- Maximum Established Patient Price $166.46
- Average Established Patient Copayment $21.22
- Minimum Established Patient Copayment $5.86
- Maximum Established Patient Copayment $41.61
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for POLLY CHUNG-PEI CHAN D.D.S.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 1 | 2 | 4 | 4 | 9 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 2 | 2 | 8 | 4 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 2 + 2 + 8 + 4 + 1 + 8 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1396124491 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 19 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1356416002 | KATRINA M POLONSKY DMD Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1912072679 | STEPHANIE RENEE DEL CARMEN DDS MS Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1811062565 | DR. TARA TAPPUNI DDS Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1821166356 | DR. STEPHEN ALLEN MIKULIC DDS Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1457411480 | DR. ANNE MATHEW BDS DDS Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1104970086 | ROBERT DAVID VERBOIS DDS Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1629357256 | CATHERINE GOEKE MEISTER DMD Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1215369426 | BARBARA BAUM Individual | Dentist (General Practice) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1467860783 | DR. LAURA YUSMAN DDS Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1508931247 | POLLY CHAN DDS INC Organization | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1316451180 | DR. KENDRA THOMAS DMD Individual | Dentist (General Practice) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1720380710 | REZA R SANJAR DMD Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1104283613 | KELLEY NGUYEN Individual | Dentist (General Practice) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1336428929 | DR. MATTHEW DAVID HASHIMOTO DDS Individual | Dentist (Orofacial Pain) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1770826406 | DR. DEREK PARK M.D., D.D.S. Individual | Dentist (Oral and Maxillofacial Surgery) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1104402593 | ZAINAB HAKIM Individual | Dentist | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1619488319 | MICHAEL CHUNG Individual | Dentist (General Practice) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1245081835 | BAHAREH FATEMI DMD Individual | Dentist (General Practice) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
| 1205409208 | TONY CAI Individual | Dentist (General Practice) | 581 FOSTER CITY BLVD FOSTER CITY, CA 94404 (650) 286-9999 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396124491, enumerated in the NPI registry as an "individual" on May 21, 2015
The provider is located at 581 Foster City Blvd Foster City, Ca 94404 and the phone number is (650) 286-9999
The provider's speciality is Dentist with taxonomy code 122300000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $104.51 with an average copayment of $26.12 for new patient appointments. Established patients should expect a typical charge of $84.91 and an average copayment of 21.22. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on September 15, 2015 to opt-out of the Medicare program. The provider is excluded from the Medicare program until September 15, 2025.
This NPI record was last updated on May 21, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.