POLLY CHUNG-PEI CHAN D.D.S.
NPI 1396124491
Dentist in Foster City, CA

Q: What is Polly Chan's NPI number?

The NPI number for Polly Chan is 1396124491. It was assigned to this individual provider in the NPPES registry on May 21, 2015.

Q: What is Polly Chan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Polly Chan enrolled in Medicare?

No. Polly Chan has opted out of Medicare through September 15, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Polly Chan was last updated on May 21, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 21, 2015Opted out of Medicare · through Sep 15, 2027

581 FOSTER CITY BLVD, FOSTER CITY, CA 94404(650) 286-9999(650) 286-9986 Get Directions Write a Review

NPPES record last updated: May 21, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Polly Chung-pei Chan D.d.s. NPPES

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

POLLY CHUNG-PEI CHAN D.D.S. (NPI 1396124491) is an individual dentist in Foster City, California, licensed in California (41166) and active in the NPI registry since May 2015. She has opted out of Medicare through September 15, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1396124491

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NamePOLLY CHUNG-PEI CHANCredential: D.D.S.

Location Address581 FOSTER CITY BLVDFoster City, CA 94404-1695

Mailing Address581 Foster City BlvdFoster City, CA 94404-1695 · (650) 286-9999 · Fax (650) 286-9986

Phone(650) 286-9999

Fax(650) 286-9986

Sole ProprietorYes

Enumeration DateMay 21, 2015

✔ NPI 1396124491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 41166

Definition

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.

581 FOSTER CITY BLVD, Foster City, CA 94404

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Polly Chung-pei Chan D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 15, 2015 through September 15, 2027.

Opt-Out Effective DateSeptember 15, 2015

Opt-Out In Effect ThroughSeptember 15, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94404 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

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.

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Other Providers at the Same Location NPPES 17

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

KELLEY NGUYEN

Dentist (General Practice)