Kerry Liza Chan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DG33259 Issued in CA

Practice address

22554 Ventura Blvd
#127
Woodland Hills, CA 91364-1413

Phone

(818) 225-7883

Fax

(818) 225-7852

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043237589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22554 VENTURA BLVD",
            "address_2": "#127",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641413",
            "telephone_number": "818-225-7883",
            "fax_number": "818-225-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22554 VENTURA BLVD",
            "address_2": "#127",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641413",
            "telephone_number": "818-225-7883",
            "fax_number": "818-225-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KERRY",
        "middle_name": "LIZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DG33259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chester Chan, MD
• Cynthia Chan
• Emily Chan
• Fanny Chan, MD
• Jaclyn Chan, DPT
• Monique L Chan
• Victoria Chan, OD
• Victoria Chan
• Vivian Chan, D.O.
• Andrea Y Chandler

• General Practice Dentistry in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.