Lily Chan, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02257700 Issued in NJ

Practice address

485 New Brunswick Ave
Suite 200
Perth Amboy, NJ 08861-3675

Phone

(732) 442-5151

NPI assigned

Apr 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942321047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 NEW BRUNSWICK AVENUE",
            "address_2": "SUITE 200",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "08861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 NEW BRUNSWICK AVE",
            "address_2": "SUITE 200",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613675",
            "telephone_number": "732-442-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02257700",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Jersey Medical Center, Inc.
• Central Jersey Medical Center, Inc.
• Central Jersey Pharmacy LLC (Central Jersey Pharmacy)
• Century Medical Group
• Dorothy Yee Chan, A.P.N.
• Kevin Li Chang
• Tahino Charrone-Ri
• Chavadentistry LLC
• Carlos Chavarria
• Jie Chen

• General Practice Dentistry in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.