Jason Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60238230 Issued in WA

Practice address

4140 Factoria Blvd SE Ste 2B
Bellevue, WA 98006-5261

Phone

(425) 746-5907

NPI assigned

Jul 19, 2012

Sex

Male

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 WA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: jchan1186417@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jason Y. Chan, DDS PLLC

  • Dental Clinic/Center
  • Bellevue, WA
  • NPI 1952948390
  NPD (past) Authorized official

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1063767614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE STE 2B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065261",
            "telephone_number": "425-746-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE STE 2B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065261",
            "telephone_number": "425-746-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60238230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Jean Champoux, LMP
• Alex Chan, DDS
• Britlynn Chan, O.D.
• Caden Chan
• Chelsea Chan
• Katharine Chan, PHARM.D
• Kay Chan, PHARMD
• Mandy Chan
• Molina Mo Wah Chan, M.D.
• Raymond K Chan, DDS

• General Practice Dentistry in Bellevue, WA
• Providers in Bellevue, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.