DR. CHARLENE RENEE CHAN (NPI# 1043349111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043349111 |
| Entity Type | Individual |
| Full Name | DR. CHARLENE RENEE CHAN |
| Credential | D.D.S., M.S.D. |
| Practice Address |
6800 Palm Ave Suite B Sebastopol CA 95472-4269 |
| Practice Telephone | 7078231200 |
| Practice Fax Number | 7078235363 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
036066 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801250220 | Charlene Chan | Family Medicine | 4960 Saint Claude Ave, New Orleans, LA 70117-4258 | 2016-04-12 |
| 1841637311 | Charlene H Chan | Social Worker | 10470 Queens Blvd, Fl 2, Forest Hills, NY 11375-3638 | 2013-05-23 |
| Street Address |
6800 PALM AVE SUITE B |
| City | SEBASTOPOL |
| State | CA |
| Zip Code | 95472-4269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811990237 | Jason Cunningham | Family Medicine | 6800 Palm Ave, Suite C, Sebastopol, CA 95472-4269 | 2005-05-31 |
| 1033531694 | Emily Ives Ramsey | Nurse Practitioner | 6800 Palm Ave, Ste C, Sebastopol, CA 95472-4269 | 2014-01-15 |
| 1548490261 | Aretaeus Telemedicine Inc. | Internal Medicine | 6800 Palm Ave, Suite K, Sebastopol, CA 95472-4269 | 2009-07-15 |
| 1538334065 | West County Health Centers, Inc. | Clinic/Center | 6800 Palm Ave, Suite C2, Sebastopol, CA 95472-4269 | 2008-04-25 |
| 1740488303 | Offsite Care, Inc | Hospitalist | 6800 Palm Ave, Suite K, Sebastopol, CA 95472-4269 | 2007-07-05 |
| 1962526574 | Gerald Earl Dixon | Dentist | 6800 Palm Ave, Suite E, Sebastopol, CA 95472-4269 | 2007-03-19 |
| 1669532446 | Gloria Kay Molica | Nurse Practitioner | 6800 Palm Ave, Suite A, Sebastopol, CA 95472-2446 | 2006-12-11 |
| 1174617708 | Rhonda Berney | Family Medicine | 6800 Palm Ave, Suite C, Sebastopol, CA 95472-4269 | 2006-10-03 |
| 1902861453 | Gregory Paul Rosa | Family Medicine | 6800 Palm Ave, D, Sebastopol, CA 95472-4269 | 2006-04-19 |
| 1235194697 | James Kelso Gude | Internal Medicine | 6800 Palm Ave, Suite K, Sebastopol, CA 95472-4269 | 2006-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916791 | Mellisa Nicole Elrod | Occupational Therapist | 1935 Gravenstein Hwy, Sebastopol, CA 95472 | 2019-08-05 |
| 1457820987 | Isabel Brooke Martinez | Acupuncturist | 961 Gravenstein Hwy South, # 100, Sebastopol, CA 95472 | 2018-11-14 |
| 1275025470 | Shahbano Syeda | Specialist/Technologist | 846/848 Gravenstein Hwy South, Sebastopol, CA 95472 | 2018-06-04 |
| 1467990812 | Mathew Metzgar | Marriage & Family Therapist | 1800 N. Gravenstein Hwy, Sebastopol, CA 95472 | 2017-02-06 |
| 1760939318 | Andrea Kirk | Psychologist | 876 Gravenstein Hwy S., Suite 6, Sebastopol, CA 95472 | 2016-09-01 |
| 1548629371 | Stacy Simons | Massage Therapist | 103 Morris St Ste V, Sebastopol, CA 95472 | 2016-02-22 |
| 1619341880 | Carol Schmid | Counselor | 1800 N, Gravenstein Hwy, Sebastopol, CA 95472 | 2015-11-25 |
| 1801273727 | Aaron Martinez | Specialist/Technologist | 7441 Witter Road, Sebastopol, CA 95472 | 2015-04-29 |
| 1699167049 | Nia Kaye | Marriage & Family Therapist | 130 Petaluma Ave Ste 2c, Sebastopol, CA 95472 | 2015-02-23 |
| 1497091383 | Caitlin Marie Kirkman | Midwife | 5611 Hessel Ave, Sebastopol, CA 95472 | 2012-12-20 |
| Find all providers in zip 95472 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091720 | Ellen Im Dds Inc | Dentist | 13422 Pomerado Rd Ste 201, Poway, CA 92064-3548 | 2020-10-21 |
| 1104425370 | Jack Bayraymyan Dental Group Inc. | Dentist | 2621 Zoe Ave Ste A, Huntington Park, CA 90255-4131 | 2020-10-20 |
| 1669071825 | Jack Bayraymyan Dental Group Inc. | Dentist | 418 E Glenoaks Blvd Ste 202, Glendale, CA 91207-2093 | 2020-10-20 |
| 1891394060 | Jack Bayraymyan Dental Group Inc. | Dentist | 600 S Alvarado St Ste 200-201, Los Angeles, CA 90057-3314 | 2020-10-20 |
| 1790391209 | Two Front Corp | Dentist | 2408 Grandview Ave, Venice, CA 90291-4938 | 2020-09-21 |
| 1396358453 | Bridget Powers | Dentist | 1000 Ygnacio Valley Rd, Walnut Creek, CA 94598-1812 | 2020-08-28 |
| 1144832221 | Manjeet Samra Dental Corporation | Dentist | 1700 Mchenry Ave Ste 16b, Modesto, CA 95350-4319 | 2020-08-19 |
| 1154932150 | Jacqueline Morgan Payne | Dentist | 1820 Sonoma Ave Ste 36, Santa Rosa, CA 95405-6617 | 2020-08-12 |
| 1922617802 | Andrew Levin | Dentist | 7891 Talbert Ave # 2, Huntington Beach, CA 92648-8612 | 2020-07-27 |
| 1861001885 | Robert Berger | Dentist | 2529 Via Sanchez, Palos Verdes Estates, CA 90274-2805 | 2020-07-26 |
| Find all providers with the same taxonomy | ||||
| City | SEBASTOPOL |
| Zip Code | 95472 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.