Individual provider Active NPI

Ella Chen, D.D.S.

  • Dentist
  • Diamond Bar, CA
National Provider Identifier
1417352675
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63543 Issued in CA
Practice address
2841 S Diamond Bar Blvd Ste B
Diamond Bar, CA 91765-3473
Phone
(909) 860-6232
Fax
(909) 594-3665
NPI assigned
Oct 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63543 CA Primary

Addresses

Primary practice location

2841 S Diamond Bar Blvd Ste B
Diamond Bar, CA 91765-3473

Mailing address

2841 S Diamond Bar Blvd Ste B
Diamond Bar, CA 91765-3473
Phone (909) 860-6232

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
I20150813010460 CA Order and Referring Only - DentistPractitioner - Dentist 1153636519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63543CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1417352675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 S DIAMOND BAR BLVD STE B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653473",
            "telephone_number": "909-860-6232",
            "fax_number": "909-594-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 S DIAMOND BAR BLVD STE B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653473",
            "telephone_number": "909-860-6232",
            "fax_number": "909-594-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ELLA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.