Justin Chan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DT-3140 Issued in HI

Practice address

65-1230 Mamalahoa Hwy Ste A21
Kamuela, HI 96743-7317

Phone

(808) 885-8465

NPI assigned

Jun 20, 2020

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Justin Chan DDS

  • Dental Clinic/Center
  • Kamuela, HI
  • NPI 1205661600
  NPD Authorized official

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

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1982220497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1230 MAMALAHOA HWY STE A21",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437317",
            "telephone_number": "586-556-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1230 MAMALAHOA HWY STE A21",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437317",
            "telephone_number": "808-885-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-20",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600517",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-3140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Case
• Kelen Rae Geller Casey, LMT
• Vikki Lynn Catellacci, MFT
• Lisa Margaret Caton, L.M.T
• Regina V Chaltry, L.M.T.
• Robin E Char, PA
• Steven J Chelminiak, LCSW
• Cherylin Garvey, M.D., LLC
• Daniel Marcus Chevy, M.D.
• Noel Ming Chia, MD

• General Practice Dentistry in Kamuela, HI
• Providers in Kamuela, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.