Individual provider Active NPI

Tiffany Chen

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1871957019
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13100 Issued in NC
Practice address
4815 Berewick Town Center Dr Ste J
Charlotte, NC 28278-6733
Phone
(704) 800-0252
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32162 TX
Dentist 122300000X 13100 NC
General Practice Dentistry 1223G0001X 32162 TX
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 13100 NC Primary

Addresses

Primary practice location

4815 Berewick Town Center Dr Ste J
Charlotte, NC 28278-6733

Mailing address

350 N Clark St FL 6
Dental Dreams LLC C/O Juliette Boyce
Chicago, IL 60654-4712

Other practice location 1

4611 Columbia Ave Ste 104
Dallas, TX 75226-2304
Phone (214) 827-8000

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
32162TXMDGeneral Practice Dentistry
13100NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alles & Associates North Carolina Dentist CurrentSince Jul 9, 2023 Accepting new patients

Locations

4815 Berewick Town Center Dr
Ste J
Charlotte, NC 28278
Phone (704) 273-1466

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1871957019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST FL 6",
            "address_2": "DENTAL DREAMS LLC C/O JULIETTE BOYCE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 BEREWICK TOWN CENTER DR STE J",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786733",
            "telephone_number": "704-800-0252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4611 Columbia Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752262304",
            "country_code": "US",
            "telephone_number": "214-827-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32162",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "13100",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32162",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 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.