Chien Yuan Cheng, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

245438 Issued in CA

Practice address

1663 Dominican Way
Suite 112
Santa Cruz, CA 95065

Phone

(831) 475-0221

Fax

(831) 475-3573

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 8, 2016 through Feb 8, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ccheng125595@santaclaravalley.direct-ci.net

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.

• Cheng DDS MD Inc and Wen S Fan DMD MD Inc a Partnership

  dba Maxillofacial Surgery Center of San Jose

  • Oral and Maxillofacial Surgery (Dentist)
  • San Jose, CA
  • NPI 1174530026
  NPD (past) Authorized official
• George M. Yellich, DDS, Ms., Inc. and Cheng, DDS, MD, Inc, Partnership

  dba Santa Cruz Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Cruz, CA
  • NPI 1881869337
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083728414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 DOMINICAN WAY",
            "address_2": "SUITE 112",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-475-0221",
            "fax_number": "831-475-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 DOMINICAN WAY",
            "address_2": "SUITE 112",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-475-0221",
            "fax_number": "831-475-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "CHIEN",
        "middle_name": "YUAN",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "245438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "45438",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANESTHESIA LICENSE",
            "identifier": "1298",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A88948",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inga Chegai
• Kateryna Chelabchi
• Jillian Margaret Chelson, PA-C
• Hsuan-Chih Chen, MD
• Peggy Chen, M.D.
• Edwin S. Cheng, MD
• Flavio Cheng
• Darla Carolyn Chenin, LAC, DACHM
• Caroline Cherng, O.D.
• Jillian Kerry Chesley, MFT

• Oral and Maxillofacial Surgery (Dentist) in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.