Individual provider Active NPI

Khanh Nhat Chau, D.M.D

  • Dentist
  • Ontario, CA
National Provider Identifier
1982087185
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64568 Issued in CA
Practice address
3640 Honey Glen Way
Ontario, CA 91761-0124
Phone
(408) 313-1938
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64568 CA Primary

Addresses

Primary practice location

3640 Honey Glen Way
Ontario, CA 91761-0124

Mailing address

3640 Honey Glen Way
Ontario, CA 91761-0124
Phone (408) 313-1938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161024001937 CA Order and Referring Only - DentistPractitioner - Dentist 8628356797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64568CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1982087185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 HONEY GLEN WAY",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917610124",
            "telephone_number": "408-313-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 HONEY GLEN WAY",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917610124",
            "telephone_number": "408-313-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAU",
        "first_name": "KHANH",
        "middle_name": "NHAT",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.