Minh Ngoc Chau, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110908 Issued in CA

Practice address

1221 N State St Ste D
San Jacinto, CA 92583-6323

Phone

(951) 462-5751

NPI assigned

Oct 14, 2024

Last updated

Oct 14, 2024By the provider in NPPES

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Justin Namm Dental Corporation

  dba Dentists of San Jacinto

  • General Practice Dentistry
  • San Jacinto, CA
  • NPI 1972221034
  NPD

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1679393680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 N STATE ST STE D",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925836323",
            "telephone_number": "951-462-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N STATE ST STE D",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925836323",
            "telephone_number": "951-462-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAU",
        "first_name": "MINH",
        "middle_name": "NGOC",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Carrillo, INTERN
• Yesenia Castaneda
• Stevelaine Celestino, LMFT
• Sinaith Casandra Cervantes
• Michelle Chalico, NP
• Chayil Birthing LLC
• Cherished Bonds LLC
• Kelly Marie Chilson, DPT
• Jennifer Chiriano
• Nansy Perez Christianson, PT

• General Practice Dentistry in San Jacinto, CA
• Providers in San Jacinto, 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 Oct 14, 2024; 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.