Healthcare Provider Details

I. General information

NPI: 1912207903
Provider Name (Legal Business Name): PETER CHASE DDS MA & TOSHI HART DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 LA CASA VIA BLDG 2 STE 104B
WALNUT CREEK CA
94598-3045
US

IV. Provider business mailing address

336 BON AIR CTR # 357
GREENBRAE CA
94904-3017
US

V. Phone/Fax

Practice location:
  • Phone: 925-935-2918
  • Fax: 925-935-2918
Mailing address:
  • Phone: 925-935-2918
  • Fax: 925-935-1532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: TOSHI HART
Title or Position: OWNER
Credential: DDS
Phone: 925-935-2918