NPIMap

Organization Active NPI

Michael T. Chan DMD Inc.

  • General Practice Dentistry
  • Rolling Hills Estates, CA
National Provider Identifier
1811613771
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MICHAEL T. CHAN DMD INC.
Doing business as
Michael T. Chan DMD Inc.
Practice address
827 Deep Valley Dr Ste 206
Rolling Hills Estates, CA 90274-3654
Phone
(310) 377-6944
NPI assigned
Oct 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Authorized official

Name
Dr. Michael Chan, DMDNPI 1073128427
Title
President
Phone
(310) 428-5861

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

827 Deep Valley Dr Ste 206
Rolling Hills Estates, CA 90274-3654

Mailing address

PO Box 3013
Palos Verdes Peninsula, CA 90274-9013
Phone (310) 428-5861

Other names 1

  • Michael T. Chan DMD Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

827 Deep Valley Dr
Ste 206
Rolling Hills Estates, CA 90274
Phone (310) 377-6944

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1811613771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3013",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749013",
            "telephone_number": "310-428-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 DEEP VALLEY DR STE 206",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743654",
            "telephone_number": "310-377-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T. CHAN DMD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-428-5861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael T. Chan DMD Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.