Jessica Phan Machado, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

65300 Issued in CA

Practice address

3991 Grand Ave Ste D
Chino, CA 91710-5442

Phone

(909) 591-0077

NPI assigned

Sep 5, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Thuy Phan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Christopher W. Leyster, DDS, a Professional Corporation

  • Pediatric Dentistry
  • Chino, CA
  • NPI 1417513987
  NPD (past)
• Linda Tran DDS a PDC

  • Pediatric Dentistry
  • Chino, CA
  • NPI 1720584790
  NPD (past)

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1992223440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16008 LEGACY RD UNIT 307",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927822812",
            "telephone_number": "949-392-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 GRAND AVE STE D",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105442",
            "telephone_number": "909-591-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHADO",
        "first_name": "JESSICA",
        "middle_name": "PHAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "65300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PHAN",
            "middle_name": "THUY",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Jean Luyten, LM, CPM
• Marc E. Lynch, D.O.
• Johnny Kae Ma, D.D.S
• Wella Jun Ma, PHARM.D
• Macadamia Holdings, LLC
• Gregory John Machnik, D.D.S.
• Ashok Kumar Madahar, M.D.
• Manpinder Kaur Madahar
• Shannon Rose Madru
• Gilan Angeles Magdangal, NP

• Pediatric Dentistry in Chino, CA
• Providers in Chino, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; 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.