Active NPI
Tiffany Chan, DDS
- Dentist
- San Jose, CA
National Provider Identifier
1558601583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61792
- Practice address
- 920 N Bascom Ave
San Jose, CA 95128-1400 - Phone
- (408) 248-4426
- NPI assigned
- Feb 28, 2013
- 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 | 61792 | CA | Primary |
Addresses
Primary practice location
920 N Bascom Ave
San Jose, CA 95128-1400
Mailing address
920 N Bascom Ave
San Jose, CA 95128-1400
Phone (408) 248-4426
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T C Mody DDS, Inc | Current | Accepting new patients |
Locations
920 N Bascom Ave
San Jose, CA 95128
Phone (408) 247-8001
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733184000000",
"number": "1558601583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 N BASCOM AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951281400",
"telephone_number": "408-248-4426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 N BASCOM AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951281400",
"telephone_number": "408-248-4426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "TIFFANY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-28",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.