Individual provider Active NPI

Maya Chane, DMD

  • General Practice Dentistry
  • Cleveland, OH
National Provider Identifier
1306117650
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-023610 Issued in OH
Practice address
10900 Euclid Ave
Cleveland, OH 44106-1712
Phone
(216) 368-3290
Fax
(216) 368-6310
NPI assigned
Jan 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-023610 OH Primary

Addresses

Primary practice location

10900 Euclid Ave
Cleveland, OH 44106-1712

Mailing address

30226 Bryce Rd
Pepper Pike, OH 44124-5710
Phone (216) 292-4971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20180206001520 OH Order and Referring Only - DentistPractitioner - Dentist 0547520843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023610OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1306117650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30226 BRYCE RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245710",
            "telephone_number": "216-292-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061712",
            "telephone_number": "216-368-3290",
            "fax_number": "216-368-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANE",
        "first_name": "MAYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-023610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.