Chun Yu Chan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02232300 Issued in NJ

Practice address

7710 Sightseeing Rd BLDG 2826
US Army Dental Activity
Fort Benning, GA 31905-3764

Phone

(706) 544-3103

NPI assigned

Dec 7, 2005

Sex

Male

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

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1659356152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 SIGHTSEEING RD BLDG 2826",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319053764",
            "telephone_number": "706-544-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 SIGHTSEEING RD BLDG 2826",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319053764",
            "telephone_number": "706-544-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHUN",
        "middle_name": "YU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02232300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario Caycedo, MD
• Joseph Cederberg, D.O.
• Mark Christian Cabog Cenon, FNP-C
• Ashley Cha, PHARM.D.
• Derek Champlin, DDS
• Calvin Dean Chandler, OD
• Jack Chandley Chapman, PSG.T
• Scott Christie
• Adele Marie Clifford, MD
• Clark Howell Cobb III, M.D.

• General Practice Dentistry in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.