Individual provider Active NPI

Chun Yu Yogi Chen, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Las Vegas, NV
National Provider Identifier
1841212461
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
S3177 Issued in NV
Practice address
10830 W Charleston Blvd Ste 130
Las Vegas, NV 89135-1194
Phone
(702) 268-7132
Fax
(725) 201-0469
NPI assigned
Jul 24, 2006
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 18640 MA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X S3177 NV Primary

Addresses

Primary practice location

10830 W Charleston Blvd Ste 130
Las Vegas, NV 89135-1194

Mailing address

3896 N MLK Blvd
North Las Vegas, NV 89032-6603
Phone (508) 904-8670

Other practice location 1

3896 N Mlk Blvd
North Las Vegas, NV 89032-6603
Phone (508) 904-8670

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
18640MAMDOrthodontics and Dentofacial Orthopedic Dentist
S3177NVMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wow Dental Orthodontics Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Marlboro Orthodontics and Associates Past Accepting new patients

Locations

10830 W Charleston Blvd
Ste 130
Las Vegas, NV 89135
Phone (702) 268-7132

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

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1841212461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3896 N MLK BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890326603",
            "telephone_number": "508-904-8670",
            "fax_number": "702-933-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10830 W CHARLESTON BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351194",
            "telephone_number": "702-268-7132",
            "fax_number": "725-201-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3896 N Mlk Blvd",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890326603",
            "country_code": "US",
            "telephone_number": "508-904-8670",
            "fax_number": "702-933-0190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "CHUN YU",
        "middle_name": "YOGI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-11-28",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "18640",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S3177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.