John M Chan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

48891 Issued in CA

Practice address

54 Fenton St
Livermore, CA 94550-4144

Phone

(925) 455-1232

Fax

(925) 371-6534

NPI assigned

Oct 26, 2010

Sex

Male

Sole proprietor

Yes

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.

• Gerald P Hawkins DDS Inc

  • General Practice Dentistry
  • Livermore, CA
  • NPI 1912061631
  NPD (past)

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1407156375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 FENTON ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504144",
            "telephone_number": "925-455-1232",
            "fax_number": "925-371-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 FENTON ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504144",
            "telephone_number": "925-455-1232",
            "fax_number": "925-371-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Centoni
• Sabena Chahal, DC
• Maria C. Chan Huynh, LMFT 101597
• Fiona Chan, PHARMACIST
• Inti Wing Chan, CMT
• Felice Elizabeth Chang, MSN RN AGCNS-BC
• Kalai Clara Chang, RPH
• Philip Chang
• Sanna Charlie, DDS
• Manpuneet Kaur Samra Chatha, M.D.

• Dentist in Livermore, CA
• Providers in Livermore, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.