Healthcare Provider Details

I. General information

NPI: 1528988193
Provider Name (Legal Business Name): ANYTIME DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NELLEN AVE
CORTE MADERA CA
94925-1148
US

IV. Provider business mailing address

101 NELLEN AVE
CORTE MADERA CA
94925-1148
US

V. Phone/Fax

Practice location:
  • Phone: 415-718-0303
  • Fax:
Mailing address:
  • Phone: 415-718-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. HSIU-CHAAI MIKE CHANG
Title or Position: CLINICAL DIRECTOR
Credential: DDS
Phone: 510-772-6393