Allison Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107785 Issued in CA

Practice address

1820 N Perris Blvd
Perris, CA 92571-2703

Phone

(951) 349-4106

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1619699691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 RANGER RD",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920288211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 N PERRIS BLVD",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712703",
            "telephone_number": "951-349-4106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40705 Winchester Rd # A103",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925915516",
            "country_code": "US",
            "telephone_number": "951-252-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ALLISON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Mary Cervantes, RADT: R1508990523
• Isabel Cervantes
• Valeria Cervantes
• Kimberly Michelle Chagolla, SLPA, B.A.
• Christina Chambers
• John Chan, PA
• Kayla Chan, AMFT/APCC
• Robin Chandler, LCSW
• Michael M Chang, MD
• Suzanne Young Chang, PHARM D

• General Practice Dentistry in Perris, CA
• Providers in Perris, 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 Sep 15, 2022; 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.