Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1194921072 Individual Practitioner Male Practitioner

Dr. Sam Tun Tan , DMD

Dentist • Represa, CA

Professional Overview & Biography Verified Profile Summary

Dr. Sam Tan, DMD is a registered healthcare professional specializing in Dentist in Represa, CA. Practice services are available at 100 PRISON RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

100 Prison Rd

Represa, CA 956713000

Telephone 9169858610
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Represa, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
12 Specialists

Practicing in Represa, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-15
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 47570

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Geneva Palmer , PhD

Psychologist - Clinical

NPI 1003088618

Doctor of Philosophy (Ph.D.)

Dr. Catherine Prudhomme , PhD

Psychologist - Clinical

NPI 1003094962

Doctor of Philosophy (Ph.D.)

Dr. Tiffanie Bell-Sprinkel , PsyD

Psychologist - Forensic

NPI 1003197773

Doctor of Psychology (Psy.D.)

Mai Thao

Student in an Organized Health Care Education/Training Program

NPI 1003787540
Dr. Susanna Farina , PhD

Psychologist - Clinical

NPI 1013089945

Doctor of Philosophy (Ph.D.)

NPI 1013330810

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location June 15, 2026

Registered at 100 PRISON RD, REPRESA, CA 956713000 (Tel: 9169858610)

📍
Updated Business Mailing Address June 15, 2026

Registered at 100 PRISON RD, REPRESA, CA 956713000 (Tel: 9169858610)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 425 ESTUDILLO AVE, SUITE C, SAN LEANDRO, CA 945774961 (Tel: 5104831543)

📍
Updated Business Mailing Address July 08, 2007

Registered at 425 ESTUDILLO AVE, SUITE C, SAN LEANDRO, CA 945774961 (Tel: 5104831543)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as SAM TAN, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #47570 in CA)

🟢
Initial NPI Registration & Enumeration June 26, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1194921072
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 26, 2007
Last Update: June 15, 2026
Sole Proprietor: Yes

Mailing Address

100 Prison Rd

Represa, CA 956713000

Phone: 9169858610

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.