Kunio Kwok-Hung Chan, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21262 Issued in MA

Practice address

655 Boston Rd
Unit 3a
Billerica, MA 01821-5338

Phone

(617) 458-2259

Fax

(978) 215-5723

NPI assigned

Jun 1, 2005

Last updated

Sep 19, 2014By the provider in NPPES

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 MA

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• One Dental Care, PC

  • General Practice Dentistry
  • Billerica, MA
  • NPI 1144624735
  NPD (past) Authorized official
• One Dental Care, PC

  dba One Dental Care

  • General Practice Dentistry
  • Brookline, MA
  • NPI 1902153752
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1245232396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOW AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024767139",
            "telephone_number": "617-458-2259",
            "fax_number": "978-215-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 BOSTON RD",
            "address_2": "UNIT 3A",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018215338",
            "telephone_number": "617-458-2259",
            "fax_number": "978-215-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KUNIO",
        "middle_name": "KWOK-HUNG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Beyond Healthcare and Staffing Agency Inc
• Tiffany L Carlson, LPN
• Kalie Anne Cassidy
• Paul R Cedrone, D.M.D.
• Yakup Cevik
• Sanford Neil Chapnick, D.C.
• Chu J Chen, MD
• Carlton Chin, RPH
• Kristen Christian, BCBA
• Maylene Chu, D.M.D.

• General Practice Dentistry in Billerica, MA
• Providers in Billerica, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.