Individual provider Active NPI

Steven Craig Chan, D.D.S.

  • General Practice Dentistry
  • Fountain Valley, CA
National Provider Identifier
1396748240
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25493 Issued in CA
Practice address
11160 Warner Ave
Ste 205
Fountain Valley, CA 92708-4048
Phone
(714) 957-1044
Fax
(714) 957-1050
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 25493 CA Primary

Addresses

Primary practice location

11160 Warner Ave
Ste 205
Fountain Valley, CA 92708-4048

Mailing address

11160 Warner Ave
Ste 205
Fountain Valley, CA 92708-4048
Phone (714) 957-1044

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160422001873 CA Order and Referring Only - DentistPractitioner - Dentist 3971802059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25493CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396748240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "STE 205",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084048",
            "telephone_number": "714-957-1044",
            "fax_number": "714-957-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "STE 205",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084048",
            "telephone_number": "714-957-1044",
            "fax_number": "714-957-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "STEVEN",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.