Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

DEREK TAN DDS
NPI 1639095276
Dentist in San Jose, CA

Q: What is Derek Tan's NPI number?

The NPI number for Derek Tan is 1639095276. It was assigned to this individual provider in the NPPES registry on June 27, 2026.

Q: What is Derek Tan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Derek Tan was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.

Active since June 27, 2026

2034 FOREST AVE STE 1A, SAN JOSE, CA 95128(408) 279-8080 Get Directions Write a Review

NPPES record added: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Derek Tan Dds NPPES

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

DEREK TAN DDS (NPI 1639095276) is an individual dentist in San Jose, California, licensed in California (113194) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1639095276

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDEREK TANCredential: DDS

Location Address2034 FOREST AVE STE 1ASan Jose, CA 95128-4809

Mailing Address2034 Forest Ave Ste 1aSan Jose, CA 95128-4809 · (408) 279-8080

Phone(408) 279-8080

Sole ProprietorNo

Enumeration DateJune 27, 2026

Last NPPES UpdateJune 29, 2026

NPPES CertifiedJune 29, 2026

✔ NPI 1639095276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 113194

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.

2034 FOREST AVE STE 1A, San Jose, CA 95128

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Other Providers at the Same Location NPPES 2

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

DEREK Y. NISHIMORI, D.D.S., INC.

Clinic/Center (Dental)

2034 FOREST AVE STE 1A
SAN JOSE, CA 95128

Santa Clara County (408) 279-8080

DR. JOHN K TANAKA DDS

Dentist

2034 FOREST AVE STE 1A
SAN JOSE, CA 95128

Santa Clara County (408) 279-8080

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 Derek Tan's NPI number?

The NPI number for Derek Tan is 1639095276. It was assigned to this individual provider in the NPPES registry on June 27, 2026.

Where is Derek Tan located?

Derek Tan practices at 2034 Forest Ave Ste 1A, San Jose, CA 95128. The listed phone number is (408) 279-8080.

What is Derek Tan's specialty?

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

When was this NPI record last updated?

The NPPES record for Derek Tan was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.