NPIMap

Organization Active NPI

Cheng DDS MD Inc and Wen S Fan DMD MD Inc a Partnership

  • Oral and Maxillofacial Surgery (Dentist)
  • San Jose, CA
National Provider Identifier
1174530026
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
45438 Issued in CA
Legal business name
CHENG DDS MD INC AND WEN S FAN DMD MD INC A PARTNERSHIP
Practice address
2039 Forest Avenue
Suite #306
San Jose, CA 95128
Phone
(408) 298-7775
Fax
(408) 298-0936
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Authorized official

Name
Dr. Chien Yvan Cheng, DDS, MDNPI 1083728414
Title
Owner/Partner
Phone
(408) 298-7775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X FNP2936 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 23580 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 45438 CA Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 52603 CA

Addresses

Primary practice location

2039 Forest Avenue
Suite #306
San Jose, CA 95128

Mailing address

2039 Forest Avenue
Suite #306
San Jose, CA 95128
Phone (408) 298-7775

Other names 1

  • Maxillofacial Surgery Center of San Jose Doing business as

National Provider Directory

National Provider Directory

Locations

2039 Forest Ave
Ste 306
San Jose, CA 95128
Phone (408) 298-7775

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1174530026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 FOREST AVENUE",
            "address_2": "SUITE #306",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-298-7775",
            "fax_number": "408-298-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 FOREST AVENUE",
            "address_2": "SUITE #306",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-298-7775",
            "fax_number": "408-298-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENG DDS MD INC AND WEN S FAN DMD MD INC A PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "CHIEN",
        "authorized_official_middle_name": "YVAN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "408-298-7775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "FNP2936",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "23580",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "45438",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "52603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maxillofacial Surgery Center of San Jose",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.