NPIMap

Organization Active NPI

Esteban Chan DMD LLC

  • General Practice Dentistry
  • Holmdel, NJ
National Provider Identifier
1548477417
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI02076102 Issued in NJ
Legal business name
ESTEBAN CHAN DMD LLC
Practice address
12 S Holmdel Rd
Holmdel, NJ 07733-2130
Phone
(732) 946-4644
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Esteban Chan, DMD
Title
Doctor
Phone
(732) 946-4644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DI02076102 NJ Primary

Addresses

Primary practice location

12 S Holmdel Rd
Holmdel, NJ 07733-2130

Mailing address

19 Heritage Dr
Edison, NJ 08820-1632
Phone (908) 757-4329

National Provider Directory

National Provider Directory
Tax ID family
Esteban Chan DMD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548477417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HERITAGE DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201632",
            "telephone_number": "908-757-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S HOLMDEL RD",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332130",
            "telephone_number": "732-946-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTEBAN CHAN DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ESTEBAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "732-946-4644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI02076102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.