Active NPI
Kelvin Chou, D.D.S
- Endodontics
- San Diego, CA
National Provider Identifier
1306156823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 102140
- Practice address
- 6235 Lusk Blvd
San Diego, CA 92121-2731 - Phone
- (858) 558-3636
- NPI assigned
- Oct 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019028505 | IL | |
| Endodontics | 1223E0200X | 102140 | CA | Primary |
Addresses
Primary practice location
6235 Lusk Blvd
San Diego, CA 92121-2731
Mailing address
6235 Lusk Blvd
San Diego, CA 92121-2731
Phone (858) 558-3636
Other practice location 1
4239 S. Archer Ave
Chicago, IL 60632
Phone (847) 461-9654
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102140 | CA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jessica Roeber, DDS | Endodontics | Current | Accepting new patients |
| Kelvin Chou DDS, Inc | Endodontics | Current | Accepting new patients |
Locations
6235 Lusk Blvd
San Diego, CA 92121
Phone (858) 558-3636
Organizations & group practices 2
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.
-
- Endodontics
- San Diego, CA
- NPI 1093558819
-
- Endodontics
- San Diego, CA
- NPI 1902568215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1306156823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6235 LUSK BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921212731",
"telephone_number": "858-558-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6235 LUSK BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921212731",
"telephone_number": "858-558-3636"
}
],
"practiceLocations": [
{
"address_1": "4239 S. Archer Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60632",
"country_code": "US",
"telephone_number": "847-461-9654",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHOU",
"first_name": "KELVIN",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-18",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019028505",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "102140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.