Daniel C. N. Chan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DNF000263 Issued in GA

Practice address

1459 Laney Walker Blvd
Ad1501
Augusta, GA 30912-0002

Phone

(706) 721-0502

Fax

(706) 721-6778

NPI assigned

May 27, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 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

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396792388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "address_2": "AD1501",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120002",
            "telephone_number": "706-721-0502",
            "fax_number": "706-721-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "address_2": "AD1501",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120002",
            "telephone_number": "706-721-0502",
            "fax_number": "706-721-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DANIEL",
        "middle_name": "C. N.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DNF000263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZG0263",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carissa Leigh Chalut, D.O
• Lindsay Chambers, MPT
• Minnie Mallard Chambliss, PT
• Champions Clinical Services, LLC
• Alisha Chan
• Jacqueline Chan, M.D.
• Samuel N. Chan, M.D.
• C Katherine Chance, MD
• Waltrina Chance, COTA
• Paul Stephen Chancellor, CRNA

• Dentist in Augusta, GA
• Providers in Augusta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.