Individual provider Active NPI

John Chan, DDS

  • Dentist
  • Turlock, CA
National Provider Identifier
1992928121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31586 Issued in CA
Practice address
2111 Geer Rd
Suite 500
Turlock, CA 95382-2458
Phone
(209) 667-2216
Fax
(209) 667-1178
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

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

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31586 CA Primary

Addresses

Primary practice location

2111 Geer Rd
Suite 500
Turlock, CA 95382-2458

Mailing address

2111 Geer Rd
Suite 500
Turlock, CA 95382-2458
Phone (209) 667-2216

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992928121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 GEER RD",
            "address_2": "SUITE 500",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822458",
            "telephone_number": "209-667-2216",
            "fax_number": "209-667-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 GEER RD",
            "address_2": "SUITE 500",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822458",
            "telephone_number": "209-667-2216",
            "fax_number": "209-667-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "31586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.