Active NPI
Diana Chan
- Dentist
- New York, NY
National Provider Identifier
1992269005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 060819
- Practice address
- 26 Broad St
New York, NY 10005-1904 - Phone
- (646) 512-8215
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 060819 | NY | Primary |
Addresses
Primary practice location
26 Broad St
New York, NY 10005-1904
Mailing address
250 E 30TH St Apt 10a
New York, NY 10016-8298
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
| License | State | Type | Specialty |
|---|---|---|---|
| 060819 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1992269005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E 30TH ST APT 10A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100168298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 BROAD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100051904",
"telephone_number": "646-512-8215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-23",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "060819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.