CHI Lok Tiffany Chan, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

106470 Issued in CA

Practice address

455 E Columbia St
Long Beach, CA 90806-1602

Phone

(562) 933-3141

NPI assigned

May 25, 2021

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1205401866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 BROOKE CT UNIT 1006",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225359",
            "telephone_number": "310-729-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E COLUMBIA ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061602",
            "telephone_number": "562-933-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2135 Westcliff Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926605543",
            "country_code": "US",
            "telephone_number": "949-722-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHI LOK TIFFANY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "106470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chamomilla Psychiatry & Wellness, a Professional Nursing Corporation
• Champion Health Plan of California
• Champion Medical Group, a Medical Corporation
• Champion Payer Solutions, LLC
• Aurelio I Chan Jr., PT
• Christina Parker Chan, RN
• Eunice Chan, AGACNP-BC
• Janen Pabello Chan, RPT
• Joanna Chan, M.D.
• Kenneth Kai Hei Chan, M.D.

• Pediatric Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.