Susie T Chan DDS a Professional Dental Corportation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

57743 Issued in CA

Legal business name

SUSIE T CHAN DDS A PROFESSIONAL DENTAL CORPORTATION

Practice address

16918 Dove Canyon Rd
Ste 201
San Diego, CA 92127-3501

Phone

(858) 924-1000

NPI assigned

Nov 7, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Susie T Ro, DDS

Title

Dentist

Phone

(714) 421-0430

Specialties & licenses 1

Addresses

Other names 1

• smile. Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Ann Wachtel, D.D.S.

  • Dentist
  • San Diego, CA
  • NPI 1154559490
  NPD (past)
• Tian Yuan, DMD

  • Dentist
  • San Diego, CA
  • NPI 1811422421
  NPD (past)

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1134473408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16918 DOVE CANYON RD",
            "address_2": "STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273501",
            "telephone_number": "858-924-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16918 DOVE CANYON RD",
            "address_2": "STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273501",
            "telephone_number": "858-924-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSIE T CHAN DDS A PROFESSIONAL DENTAL CORPORTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "RO",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "714-421-0430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "57743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "smile.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan'S Hair Unlimited ,Inc
• Aleah Celine Susana
• La'Shay Suseberry
• Susie C. Kwok DDS Inc
• Susie Ro, Licensed Clinical Social Worker, Path to Healing, Inc,
• Alissa Sara Suski, M.A., CCC-SLP
• Davis Alan Suskind, M.D.
• Naomi Suskind, ASW
• Paul Robert Sussman, PH.D.
• Sustain Community Acupuncture

• Dental Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.