Adriana Jade Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011561 Issued in AZ

Practice address

Naval Hospital Camp Pendleton
200 Mercy Circle
Camp Pendleton, CA 92055

Phone

(626) 466-8677

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1598484727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL CAMP PENDLETON",
            "address_2": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL CAMP PENDLETON",
            "address_2": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "626-466-8677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Medical Center 34800 Bob Wilson Drive",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921340001",
            "country_code": "US",
            "telephone_number": "760-725-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ADRIANA",
        "middle_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VAD0000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Caviness Jr., M.D.
• Jed Vicente Cayanan, SOIDC
• Pernilla K Cederqvist, RDH
• Sook Kueen Chai, DMD
• Nancy Jo Chamberlain, RN
• Ryan Lucas Charter, PA-C
• Giang-Tien Chau, PHARM.D.
• Meera Cheerharan, MD
• John Chen, MD
• Hen Jin Cheng, D.O.

• General Practice Dentistry in Camp Pendleton, CA
• Providers in Camp Pendleton, 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 Aug 26, 2022; 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.