Stephen L Chan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36345 Issued in CA

Practice address

4700 Spring St
Suite 210
La Mesa, CA 91941-5263

Phone

(619) 464-2801

Fax

(619) 464-2802

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

No

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 CA

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

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.

• Stephen L. Chan , D.M.D , Inc.

  • General Practice Dentistry
  • La Mesa, CA
  • NPI 1437564507
  NPD (past) Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366575920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SPRING ST",
            "address_2": "SUITE 210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415263",
            "telephone_number": "619-464-2801",
            "fax_number": "619-464-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SPRING ST",
            "address_2": "SUITE 210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415263",
            "telephone_number": "619-464-2801",
            "fax_number": "619-464-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aldin Jimmy Baal Cerillo, OTD, OTR/L
• Certified Hand Solutions Inc
• Rigoberto Cervantes, D.D.S.
• Sabina Natalie Cervantes, MFT
• Roman B Cham, MD
• Rosalinda Chandarlis
• Carson Chandler, PT, DPT
• Chanel'S Hair Boutique
• Daniel Chang, D.O.
• Weiling Chang, M.D.

• General Practice Dentistry in La Mesa, CA
• Providers in La Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.