Gregory Chan, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DDS107368 Issued in CA

Practice address

8211 Bruceville Rd Ste 155
Sacramento, CA 95823-2313

Phone

(916) 525-7635

NPI assigned

Jul 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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.

• Min Dental Corporation

  • General Practice Dentistry
  • Sacramento, CA
  • NPI 1881884724
  NPD (past)

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1508419797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19736 AUBURN DR",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142414",
            "telephone_number": "408-221-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 BRUCEVILLE RD STE 155",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232313",
            "telephone_number": "916-525-7635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "188 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155819",
            "country_code": "US",
            "telephone_number": "617-432-1434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "GREGORY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858442",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1858442",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "DDS107368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cora Chan
• Crystal Chan
• Derrick W Chan, MD
• Eva Yeewah Chan, M.D.
• Frankie Chan
• Hazel Chan
• Hung Chan, M.D.
• Jacinda Chan
• Jeddy Chan
• Jessica Chan

• Periodontics in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.