Individual provider Active NPI

Christopher M Chen, DDS

  • Dentist
  • Aurora, IL
National Provider Identifier
1891932315
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19027612 Issued in IL
Practice address
1940 W Galena Blvd
Aurora, IL 60506-4319
Phone
(630) 892-7041
Fax
(630) 892-0241
NPI assigned
Jan 21, 2009
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19027612 IL Primary

Addresses

Primary practice location

1940 W Galena Blvd
Aurora, IL 60506-4319

Mailing address

22W029 Valleyview Dr
Glen Ellyn, IL 60137-3637
Phone (630) 532-3406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160330002526 IL Order and Referring Only - DentistPractitioner - Dentist 6800193129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19027612ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
C & T Dental Care Past Accepting new patients

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, 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": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1891932315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22W029 VALLEYVIEW DR",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373637",
            "telephone_number": "630-532-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064319",
            "telephone_number": "630-892-7041",
            "fax_number": "630-892-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19027612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.