Active NPI
Jason Chen
- Oral and Maxillofacial Surgery (Dentist)
- Flushing, NY
National Provider Identifier
1871174532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 064850
- Practice address
- 3530 Francis Lewis Blvd Ste 205
Flushing, NY 11358-1959 - Phone
- (718) 762-2340
- NPI assigned
- Apr 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 064850 | NY | Primary |
Addresses
Primary practice location
3530 Francis Lewis Blvd Ste 205
Flushing, NY 11358-1959
Mailing address
71 Udall Dr
Great Neck, NY 11020-1529
Phone (646) 734-0592
Other practice location 1
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210628001413 | CT | Order and Referring Only - Oral Surgery | 2668871104 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064850 | NY | MD | Pharmacist |
Interoperability endpoints
- jchen515075@direct.ynhh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1871174532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 UDALL DR",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110201529",
"telephone_number": "646-734-0592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 FRANCIS LEWIS BLVD STE 205",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113581959",
"telephone_number": "718-762-2340"
}
],
"practiceLocations": [
{
"address_1": "20 York St",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103220",
"country_code": "US",
"telephone_number": "203-688-4242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHEN",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-15",
"last_updated": "2025-07-28",
"certification_date": "2025-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NY",
"license": "064850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.