Jimmy Cham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37088 Issued in CA

Practice address

2139 Tully Rd
San Jose, CA 95122-1346

Phone

(408) 259-5660

NPI assigned

Jul 7, 2005

Reactivated

Apr 6, 2006

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

State licenses

Practice roles

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.

• Jimmy Cham DDS a Professional Corporation

  • Dentist
  • San Jose, CA
  • NPI 1104027614
  NPD (past) Authorized official
• P S Chu, DDS, Inc

  dba 3 star dental center

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1790834679
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1164429916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221346",
            "telephone_number": "408-259-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221346",
            "telephone_number": "408-259-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAM",
        "first_name": "JIMMY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline S Chak, M.D.
• Sudeshna Chakrabarti, OTR/L
• Rae Magid Chalin
• Vadim Chalov, L.AC
• Sujatha Chaluvadi
• Peter Man Hon Cham, MD
• Bradley Chamberlin
• Emily R Chamberlin, NP
• Sara Chamberlin, PSYD
• Chambers Chiropractic Center, Inc.

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, 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 Mar 16, 2020; 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.