Jennifer M Chan, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60487956 Issued in WA

Practice address

10414 Beardslee Blvd Ste 200
Bothell, WA 98011-3205

Phone

(425) 424-6350

NPI assigned

Sep 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jchan20222@healthpoint.direct-ci.com
• Direct secure messaging: jennifer.chan.p3@direct.hpc.nextgenshare.com

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.

• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Seatac, WA
  • NPI 1831778620
  NPD (past)

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1295069045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10414 BEARDSLEE BLVD STE 200",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113205",
            "telephone_number": "425-424-6350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Wright Patterson AFB Hospital",
            "address_purpose": "LOCATION",
            "city": "Wright Patterson AFB",
            "state": "OH",
            "postal_code": "45433",
            "country_code": "US",
            "telephone_number": "937-257-8761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22D102422200",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60487956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchan20222@healthpoint.direct-ci.com",
            "affiliation": "N",
            "address_1": "10414 Beardslee Blvd Ste 200",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980113205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremy B Chaison, DDS, MSD
• Cham Anesthesia Services LLC
• Chan Braces
• Denise Chan
• Janus Chan
• Richard Wilkin Chan, DDS MS
• Sara Ann Chandler, LMHCA
• Elizabeth Y. Chang, O.D.
• Heng Chang, OTD, OTR/L
• Kimberly A Chapman, DDS

• All providers in Bothell, WA
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.