Individual provider Active NPI

Jason Chen, DDS

  • General Practice Dentistry
  • Downey, CA
National Provider Identifier
1164141479
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107848 Issued in CA
Practice address
7601 Imperial Hwy
Downey, CA 90242-3456
Phone
(562) 385-7111
NPI assigned
Aug 22, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 107848 CA Primary

Addresses

Primary practice location

7601 Imperial Hwy
Downey, CA 90242-3456

Mailing address

4343 Macarthur Blvd # 1060
Newport Beach, CA 92660-2021

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241108003702 CA Order and Referring Only - DentistPractitioner - Dentist 2860926193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107848CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1164141479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 MACARTHUR BLVD # 1060",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423456",
            "telephone_number": "562-385-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JASON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.