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EDRICK TAN DDS
NPI 1083446892
Dentist - General Practice in San Jose, CA

Active since August 19, 2024PECOS Enrolled
1315 S WINCHESTER BLVD, SAN JOSE, CA 95128(408) 866-1819 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Edrick Tan Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDRICK TAN DDS (NPI 1083446892) is an individual general practice provider in San Jose, California, licensed in California (110427) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083446892
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameEDRICK TANCredential: DDS
Location Address1315 S WINCHESTER BLVDSan Jose, CA 95128-4320
Mailing Address521 E Longden AveArcadia, CA 91006-5351
Phone(408) 866-1819
Sole ProprietorYes
Enumeration DateAugust 19, 2024
NPPES CertifiedAugust 19, 2024
✔ NPI 1083446892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 110427
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1315 S WINCHESTER BLVD, San Jose, CA 95128
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edrick Tan Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THAI HUNG DENTAL CORPORATION
Dentist
1315 S WINCHESTER BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 866-1819
DR. EKTA GUPTA DDS
Dentist
1315 S WINCHESTER BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 866-1819
XIAO LI
Dentist (General Practice)
1315 S WINCHESTER BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 866-1819
HUNG THAI DENTAL CORP
Dentist
1315 S WINCHESTER BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 866-1819

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edrick Tan's NPI number?

The NPI number for Edrick Tan is 1083446892. It was assigned to this individual provider in the NPPES registry on August 19, 2024.

Where is Edrick Tan located?

Edrick Tan practices at 1315 S Winchester Blvd, San Jose, CA 95128. The listed phone number is (408) 866-1819.

What is Edrick Tan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Edrick Tan enrolled in Medicare?

Yes. Edrick Tan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Edrick Tan was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.