Individual provider Active NPI

Michelle Chan, DMD

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1154707727
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
00000 Issued in ZZ
Practice address
625 Elmwood Ave
Rochester, NY 14620-2913
Phone
(585) 275-5087
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 00000 ZZ Primary

Addresses

Primary practice location

625 Elmwood Ave
Rochester, NY 14620-2913

Mailing address

625 Elmwood Ave
Rochester, NY 14620-2913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00000ZZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1154707727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913",
            "telephone_number": "585-275-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MICHELLE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ZZ",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.