Individual provider Active NPI

Chanyoung Sean CHI, D.D.S.

  • Public Health Dentistry
  • Aurora, CO
National Provider Identifier
1891877650
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DEN.00202487 Issued in CO
Practice address
3292 Peoria St
Aurora, CO 80010-1517
Phone
(303) 343-7277
Fax
(303) 343-7290
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 54728 CA
Public Health Dentistry 1223D0001X DEN.00202487 CO Primary

Addresses

Primary practice location

3292 Peoria St
Aurora, CO 80010-1517

Mailing address

3701 S Broadway
Englewood, CO 80113-3611
Phone (303) 360-6276

Other practice location 1

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20210223000825 CO Practitioner - Dentist 1850652603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54728CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Feb 1, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Feb 1, 2021 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

301 W 6th Ave
Denver, CO 80204
Phone (303) 602-8070

Interoperability endpoints

  • Direct secure messaging: cchi181766@direct.dhha.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1891877650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133611",
            "telephone_number": "303-360-6276",
            "fax_number": "303-467-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 PEORIA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800101517",
            "telephone_number": "303-343-7277",
            "fax_number": "303-343-7290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044597",
            "country_code": "US",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-4560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHI",
        "first_name": "CHANYOUNG",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54728",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CO",
            "license": "DEN.00202487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.