Dr. Micah Chan
Periodontist
6601 Lyndale Ave S
Richfield
, Minnesota 55423-2477
Dr. Micah Chan
Periodontist
6601 Lyndale Ave S
Richfield
, Minnesota 55423-2477
(612) 910-6203
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Micah Chan
- 8301 Stanley Rd Apt #114
- Bloomington, MN
- Zip : 55437-1282
- Phone : (612) 910-6203
Second Address
- Dr. Micah Chan
- 6601 Lyndale Ave S
- Richfield, MN
- Zip : 55423-2477
- Phone : (612) 243-9357
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | S99 | MN |
National Provider Identifier
| NPI | 1083083323 |
|---|---|
| Provider Name | Dr. Micah Chan |
| First Address | Bloomington, MN 55437-1282 |
| Second Address | Richfield, MN 55423-2477 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/09/2015 |
| Last Update Date | 16/09/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.