Michael Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104013 Issued in CA

Practice address

6221 Metropolitan St
Carlsbad, CA 92009-3096

Phone

(760) 602-9500

NPI assigned

Jul 17, 2019

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

Practice roles

Locations

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.

• Will & Chan Dental Corporation

  • Dental Clinic/Center
  • Encinitas, CA
  • NPI 1780272344
  NPD Authorized official

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1669025797",
    "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",
            "telephone_number": "951-743-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 METROPOLITAN ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920093096",
            "telephone_number": "760-602-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla A. Chairez
• Sasha Chakrabarty
• Savannah Chambers
• Larry J. Chamow, PHD
• Azure Champlain
• Julie Chandler
• Diya Sabrina Chandra, DMD
• Pamela Chang Ibanez
• Jennifer Mallory Chang, PT, DPT
• Susan S Chang, PHARMD

• General Practice Dentistry in Carlsbad, CA
• Providers in Carlsbad, 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 Jan 3, 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.