Justin Nile Chan, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

27969 Issued in TX

Practice address

6675 S Custer Rd Ste 200
McKinney, TX 75070-1838

Phone

(469) 301-3212

Fax

(469) 301-3213

NPI assigned

Jul 22, 2011

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

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 May 12, 2016 through May 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sprout Dentistry for Kids Allen, PLLC

  dba Sprout Dentistry for Kids

  • Pediatric Dentistry
  • Allen, TX
  • NPI 1366198921
  NPD Authorized official

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1144508292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 S CUSTER RD STE 200",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750701838",
            "telephone_number": "469-301-3212",
            "fax_number": "469-301-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 S CUSTER RD STE 200",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750701838",
            "telephone_number": "469-301-3212",
            "fax_number": "469-301-3213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 W Stacy Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750135049",
            "country_code": "US",
            "telephone_number": "469-663-0098",
            "fax_number": "469-663-0097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JUSTIN",
        "middle_name": "NILE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "27969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lajuan Jones Chambers, MD
• Nancey Elizabeth Chambers, M.D.
• Rebecca Chambers
• Mallory Champagne
• Nicole Champlin
• Renee L. Chan, M.D.
• Becky L Chandler, M.D.
• Bill PO Wei Chang, D.D.S.
• Daniel E Chang, D.M.D.
• Kevin Chang

• Pediatric Dentistry in McKinney, TX
• Providers in McKinney, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.