Jonathan Karl Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43123 Issued in CA

Practice address

935 Roseville Parkway, #120
Roseville, CA 95678

Phone

(916) 771-8828

Fax

(916) 771-8558

NPI assigned

Mar 8, 2007

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 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

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1144351685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 ROSEVILLE PARKWAY, #120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95678",
            "telephone_number": "916-771-8828",
            "fax_number": "916-771-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 ROSEVILLE PARKWAY, #120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95678",
            "telephone_number": "916-771-8828",
            "fax_number": "916-771-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JONATHAN",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa del Carmen Chamberlain
• Kathryn Chambers
• Sarah Champany
• Danielle M Chan, MD
• Diane L. Chan, MD
• Kenneth K.M. Chan, MD
• Louis Chan, RCP, RRT, RPFT
• Catherine Chandavong, NP
• Graham Chandler
• Aarti Lata Chandra

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, 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 Apr 17, 2018; 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.