Ted Chan, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44153 Issued in CA

Practice address

816 W Willow St
Long Beach, CA 90806-2837

Phone

(562) 595-7077

Fax

(562) 608-8356

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

No

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

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.

• Elizabeth L Hoang DMD & Ted Chan DMD, Inc

  • Dentist
  • Long Beach, CA
  • NPI 1518465715
  NPD (past) Authorized official
• Omega Family Dental

  • General Practice Dentistry
  • Long Beach, CA
  • NPI 1396250353
  NPD (past) Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1508997784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062837",
            "telephone_number": "562-595-7077",
            "fax_number": "562-490-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062837",
            "telephone_number": "562-595-7077",
            "fax_number": "562-608-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TED",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janen Pabello Chan, RPT
• Joanna Chan, M.D.
• Kenneth Kai Hei Chan, M.D.
• Loren Rachel Chan, CPNP-PC, RN
• Sripha Ouk Chan, MD
• Vanessa Chan, D.O.
• Victoria Chan, M.S., CFY-RPE
• Vivian Chan, DPM
• Wendy Chan, RN
• Robin Joelle Chancer, L.C.S.W.(CA), LISW-S

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, 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 Dec 7, 2017; 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.