Active NPI
Chelsea S Chin
- General Practice Dentistry
- Fountain Valley, CA
National Provider Identifier
1417422155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46038
- Practice address
- 18025 Brookhurst St
Fountain Valley, CA 92708-6738 - Phone
- (714) 968-4500
- NPI assigned
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46038 | CA | Primary |
Addresses
Primary practice location
18025 Brookhurst St
Fountain Valley, CA 92708-6738
Mailing address
18025 Brookhurst St
Fountain Valley, CA 92708-6738
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46038 | CA | MD | Respiratory/Developmental/Rehabilitative Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chelsea S. Chin DDS a Dental Corportaion | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Fountain Valley, CA
- NPI 1396859344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1417422155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18025 BROOKHURST ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927086738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18025 BROOKHURST ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927086738",
"telephone_number": "714-968-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "CHELSEA",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-09",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.