Justin Chan DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JUSTIN CHAN DDS

Practice address

65-1230 Mamalahoa Hwy Ste A21
Kamuela, HI 96743-7317

Phone

(586) 556-0220

NPI assigned

Sep 4, 2024

Last updated

Jan 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Chan, DDSNPI 1982220497

Title

Dentist

Phone

(586) 556-0220

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Chan, DDS

  • General Practice Dentistry
  • Kamuela, HI
  • NPI 1982220497
  NPD Authorized official

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1205661600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1230 MAMALAHOA HWY STE A21",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437317",
            "telephone_number": "586-556-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1230 MAMALAHOA HWY STE A21",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437317",
            "telephone_number": "586-556-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN CHAN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "586-556-0220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter R. Jaeckle I, PH.D.
• John Mascaro PHD
• Nancy N. Johnson, M.A.
• Paul E. Johnston, MD
• Troy Alan Jones, MPT
• Kristi Kaapu, MSW
• Patty Ann Kaholokula, MSW
• Kaiao Ola Integrative Healing, LLC
• Kaiser Foundation Health Plan Inc (Kaiser Waimea Clinic Laboratory)
• Kaiser Foundation Health Plan, Inc

• Dental Clinic/Center in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Dental Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.