NPIMap

Individual provider Active NPI

Chun Tan, D.M.D.

  • General Practice Dentistry
  • Rockville, MD
National Provider Identifier
1639457948
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15001 Issued in MD
Practice address
15204 Omega Dr Ste 250
Rockville, MD 20850-4601
Phone
(240) 580-8818
Fax
(240) 580-8819
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15001 MD Primary

Addresses

Primary practice location

15204 Omega Dr Ste 250
Rockville, MD 20850-4601

Mailing address

8516 Bells Ridge Ter
Potomac, MD 20854-2793
Phone (443) 763-6658

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

State licenses

LicenseStateTypeSpecialty
15001MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bestadental LLC CurrentSince Mar 1, 2020 Accepting new patients
Saint Elizabeths Hospital General Practice PastSince Oct 1, 2019 Accepting new patients
DRS. Batz & Weiner General Practice Past Accepting new patients

Locations

15204 Omega Dr
Ste 250
Rockville, MD 20850
Phone (240) 580-8818

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1639457948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8516 BELLS RIDGE TER",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542793",
            "telephone_number": "443-763-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 OMEGA DR STE 250",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504601",
            "telephone_number": "240-580-8818",
            "fax_number": "240-580-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "CHUN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.