Heidi L Chan DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

46035 Issued in CA

Legal business name

HEIDI L CHAN DDS INC

Practice address

9241 Reseda Blvd
Suite 104
Northridge, CA 91324

Phone

(818) 709-4400

Fax

(818) 709-4056

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Heidi L Chan, DDSNPI 1255882403

Title

Dentist

Phone

(818) 709-4400

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heidi Chan

  • General Practice Dentistry
  • Northridge, CA
  • NPI 1255882403
  NPD (past) Authorized official

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1609922442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 RESEDA BLVD",
            "address_2": "SUITE 104",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91324",
            "telephone_number": "818-709-4400",
            "fax_number": "818-709-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 RESEDA BLVD",
            "address_2": "SUITE 104",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91324",
            "telephone_number": "818-709-4400",
            "fax_number": "818-709-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIDI L CHAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-709-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Northridge, CA
• Providers in Northridge, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.