Leonard M Chance Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00004909 Issued in WA

Practice address

104 W 3Rd St
Port Angeles, WA 98362-2825

Phone

(360) 452-9744

Fax

(360) 452-5861

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073686341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 STRAIT VIEW DR",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983628473",
            "telephone_number": "360-457-4366",
            "fax_number": "360-457-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 3RD ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622825",
            "telephone_number": "360-452-9744",
            "fax_number": "360-452-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "LEONARD",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00004909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50200-03",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Certified Hearing Inc.
• Certified Medical Supply, Inc.
• Karla Chamberlin
• Darrell Ray Chambers, CDPT
• David Lane Chance, D.D.S.
• Matthew Ryan Chance, ARNP
• Victoria Amara Chaney
• Darren Thomas Chapman, DPT
• Roberta L Charles, ME, CAS,LMHC
• Roxanne Irene Charles

• General Practice Dentistry in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.