Andrew Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61463544 Issued in WA

Practice address

325 Squire Hall
Buffalo, NY 14214-8006

Phone

(716) 262-9750

NPI assigned

Jun 21, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1124703533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 15TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981445725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142148006",
            "telephone_number": "716-262-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-08-17",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61463544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyne Marie Chamberlain
• Deborah Chamberlin, RN
• Sarah Chamberlin, RN
• Daisy Chambers, MSW
• Michael Chambers
• Arthur Chan
• Jon Michael Chan, M.D.
• Kevin Kuang Hui Chan, DO
• Meagan Chandarana, PHARMD
• Unjali Chandra

• General Practice Dentistry in Buffalo, NY
• Providers in Buffalo, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.