Christopher Chan, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS64007 Issued in CA

Practice address

212 S El Molino Ave
Pasadena, CA 91101-6501

Phone

(626) 792-3161

Fax

(626) 792-9442

NPI assigned

Apr 9, 2013

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

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

Credentials

Doctor of Medicine

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.

• Christopher Chan, DDS, MD, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Pasadena, CA
  • NPI 1255074381
  NPD Authorized official
• Central Dental Group

  • General Practice Dentistry
  • Monterey Park, CA
  • NPI 1245308923
  NPD (past)
• Ryan S C Lee,a Professional Dental Corporation

  • Dentist
  • Monterey Park, CA
  • NPI 1225430473
  NPD (past)

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1164865242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 S MARGUERITA AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033143",
            "telephone_number": "310-886-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S EL MOLINO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911016501",
            "telephone_number": "626-792-3161",
            "fax_number": "626-792-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N State St",
            "address_2": "Dept of Dentistry, A3C Dental Clinic",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-409-1558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2111 S Atlantic Blvd",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917546801",
            "country_code": "US",
            "telephone_number": "323-261-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8540 S Sepulveda Blvd Ste 1206",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900453819",
            "country_code": "US",
            "telephone_number": "310-641-6124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-04-30",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS64007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Chan
• Charissa Chan
• Cheri Chan
• Christie Chan, OD
• Christine W Chan, O.D.
• Eugenia Chan, D.D.S.
• Jane Wor Chan, MD
• Jasper Chan
• Milton D Chan, D.D.S.
• Tiffany Chan

• Oral and Maxillofacial Surgery (Dentist) in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.