Active NPI
Jamie Chan, DMD
- Dentist
- Woburn, MA
National Provider Identifier
1437888104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1859484
- Practice address
- 474 Main St
Woburn, MA 01801-4236 - Phone
- (781) 604-3999
- NPI assigned
- Jun 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN1859484 | MA | Primary |
Addresses
Primary practice location
474 Main St
Woburn, MA 01801-4236
Mailing address
474 Main St
Woburn, MA 01801-4236
Phone (781) 604-3999
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 |
|---|---|---|---|
| DN1859484 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woburn Dentistry PC | Dentist | Current | Accepting new patients |
Locations
474 Main St
Woburn, MA 01801
Phone (781) 604-3999
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1437888104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 MAIN ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018014236",
"telephone_number": "781-604-3999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 MAIN ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018014236",
"telephone_number": "781-604-3999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "JAMIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-08",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MA",
"license": "DN1859484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.