NPIMap

Individual provider Active NPI

Raymond K Chan, DDS

  • Dentist
  • Bellevue, WA
National Provider Identifier
1932267796
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00005695 Issued in WA
Practice address
4140 Factoria Blvd SE
#2B
Bellevue, WA 98006
Phone
(425) 746-5907
Fax
(425) 746-1688
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00005695 WA Primary

Addresses

Primary practice location

4140 Factoria Blvd SE
#2B
Bellevue, WA 98006

Mailing address

4140 Factoria Blvd SE
#2B
Bellevue, WA 98006
Phone (425) 746-5907

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
DE00005695WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason Y. Chan, DDS PLLC PastSince Dec 9, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932267796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE",
            "address_2": "#2B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98006",
            "telephone_number": "425-746-5907",
            "fax_number": "425-746-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE",
            "address_2": "#2B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98006",
            "telephone_number": "425-746-5907",
            "fax_number": "425-746-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "RAYMOND",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00005695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.