DR. MICAH CHAN (NPI# 1083083323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083083323 |
Entity Type | Individual |
Full Name | DR. MICAH CHAN |
Credential | D.M.D., M.S. |
Practice Address |
6601 Lyndale Ave S Richfield MN 55423-2477 |
Mailing Address |
8301 Stanley Rd Apt #114 Bloomington MN 55437-1282 |
Practice Telephone | 6122439357 |
Mailing Telephone | 6129106203 |
Enumeration Date | 2015-09-16 |
Last Update Date | 2015-09-16 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
S99 | MN | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659322048 | Micah R Chan | Internal Medicine | 3034 Fish Hatchery Rd Ste B, Uw Nephrology, Fitchburg, WI 53713-3125 | 2006-05-12 |
Street Address |
6601 LYNDALE AVE S |
City | RICHFIELD |
State | MN |
Zip Code | 55423-2477 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336114644 | Joseph Shaun Hicken | Dentist | 6601 Lyndale Ave S, Suite 240, Richfield, MN 55423-2477 | 2006-02-21 |
1891336863 | Jesse Elaine Olson | Nurse Practitioner | 6601 Lyndale Ave S, Richfield, MN 55423-2477 | 2019-10-01 |
1134637457 | Downtown Eyes Crosstown Pllc | Ophthalmology | 6601 Lyndale Ave S, Richfield, MN 55423-2477 | 2018-01-22 |
1356724975 | Benjamin David Larson | Dentist | 6601 Lyndale Ave S, Richfield, MN 55423-2477 | 2015-07-01 |
1689076432 | Laura Richardson | Physical Therapist | 6601 Lyndale Ave S, #105, Richfield, MN 55423 | 2014-09-24 |
1962785881 | Mary C Nolan | Nurse Practitioner | 6601 Lyndale Ave S, Suite 220, Richfield, MN 55423-2477 | 2011-09-27 |
1558689778 | Andrew Esten | Internal Medicine | 6601 Lyndale Ave S, Suite 220, Richfield, MN 55423-2477 | 2010-05-12 |
1003043175 | Rebecca Leigh Benson | Dentist | 6601 Lyndale Ave S, Richfield, MN 55423-2477 | 2009-06-16 |
1639356785 | Jan Mari Young | Physical Therapy Assistant | 6601 Lyndale Ave S, 105, Richfield, MN 55423-2477 | 2008-01-30 |
1629277082 | Perspectives Optometric Vision Clinic, PC | Optometrist | 6601 Lyndale Ave S, Richfield, MN 55423-2477 | 2007-07-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841844081 | Ann Niebuhr | Counselor | 6417 Penn Ave S Ste 8 #2, Minneapolis, MN 55423 | 2019-07-25 |
1073021077 | Alton John Olson | Surgery | 7008 - Morgan Avenue South, Richfield, MN 55423 | 2018-01-12 |
1992238190 | Certified Care Planner LLC | Home Health | 1515 E 66th Street Suite 105, Richfield, MN 55423 | 2017-04-05 |
1245780121 | Rachel Lauren Marston | Audiologist | 7745 2nd Ave S., Suite 1, Richfield, MN 55423 | 2016-10-04 |
1023564093 | Justine Welch Mastin | Counselor | 6640 Lyndale Ave S Ste 110, Minneapolis, MN 55423 | 2016-08-30 |
1215480942 | Smart Choice Mri, LLC | Clinic/Center | 1704 E 66th St, Minneapolis, MN 55423 | 2016-07-29 |
1225425531 | Maria Lourdes Nolasco De Leon | Registered Nurse | 6511 12th Ave. S, Richfield, MN 55423 | 2015-04-24 |
1508261926 | Ally Medical Supply | Durable Medical Equipment & Medical Supplies | 6238 Lyndale Ave South, Suite # 2, Richfield, MN 55423 | 2014-10-28 |
1811230097 | Barb Rose Olson | Registered Nurse | 6461 Lyndale Ave. So, Richfield, MN 55423 | 2013-04-05 |
1902149404 | Nina Kae Hanevik | Registered Nurse | 6461 Lyndale Ave So, Richfield, MN 55423 | 2013-04-03 |
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Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134403611 | Erik M Unger | Dentist | 6411 Richfield Pkwy, Richfield, MN 55423-6400 | 2011-10-03 |
1063512234 | Family Periodontic Specialists, Plc | Dentist | 6601 Lyndale Ave S, Suite 220, Richfield, MN 55423-2477 | 2006-09-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316400591 | Shorouk Elnagdy | Dentist | 515 Delaware St Se # 7-368, Minneapolis, MN 55455-0357 | 2019-04-13 |
1508300252 | Minnesota Periodontal Associates, Pa | Dentist | 4801 Hwy 61 N., Suite 300, White Bear Lake, MN 55110-2753 | 2016-12-15 |
1164978672 | Benjamin Halpern | Dentist | 14344 Burnhaven Drive, Burnsville, MN 55306 | 2016-08-26 |
1356684419 | Shahir Nehad Abdel-malek | Dentist | 3555 Louisiana Ave S, Saint Louis Park, MN 55426-4121 | 2013-03-27 |
1386901858 | Jeanne L Barss | Dentist | 2550 University Ave W Ste 189s, Saint Paul, MN 55114-2001 | 2012-04-20 |
1205129012 | Jerod Thomas Klava | Dentist | 6545 France Ave. So., Suite 190, Edina, MN 55435 | 2011-05-26 |
1861784050 | Elham Akhlaghi | Dentist | 515 Delaware Street, Minneapolis, MN 55455 | 2011-05-06 |
1013216811 | Minneapolis-st. Paul Periodontics | Dentist | 1109 East Moore Lake Drive, Fridley, MN 55432 | 2011-03-18 |
1558516369 | Mdo Periodontics Pa | Dentist | 1900 Kruchten Ct S, Ste. 101, Sartell, MN 56377-4730 | 2008-11-20 |
1972770006 | Ying-lien Wu | Dentist | 150 S 5th St Ste 1475, Minneapolis, MN 55402-4212 | 2008-05-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.