Derrick M Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29023 Issued in CA

Practice address

1828 Clement St
San Francisco, CA 94121-2207

Phone

(415) 221-5200

Fax

(415) 221-9444

NPI assigned

Dec 19, 2006

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

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417011271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212207",
            "telephone_number": "415-221-5200",
            "fax_number": "415-221-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212207",
            "telephone_number": "415-221-5200",
            "fax_number": "415-221-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DERRICK",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lee Chan, DPT
• David Koon Chan, DC
• Denise Chan
• Dennis S. Chan, D.D.S.
• Derrick Chan
• Doris Gee Chan, DTR
• Edith Y Chan, L.AC.
• Edmund Chan, RN
• Edward Y C Chan, M.D.
• Eileen Chan, O.D.

• General Practice Dentistry in San Francisco, CA
• Providers in San Francisco, 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.