Simon Chanin

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS0000011186 Issued in TN

Practice address

3071 Kirby Whitten Rd
Bartlett, TN 38134-2822

Phone

(901) 382-1564

NPI assigned

Oct 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bartlett Pediatric Dentistry

  • Pediatric Dentistry
  • Bartlett, TN
  • NPI 1952425282
  NPD (past)
• Timothy P. Bakelaar, D.M.D, PLLC

  dba Bartlett Pediatric Dentistry and Orthodontics

  • Pediatric Dentistry
  • Bartlett, TN
  • NPI 1043534829
  NPD (past)

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1083124184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 E GE PATTERSON AVE APT 102",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034500",
            "telephone_number": "901-626-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 KIRBY WHITTEN RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342822",
            "telephone_number": "901-382-1564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 SW Moody Ave",
            "address_2": "Department of Orthodontics",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97201",
            "country_code": "US",
            "telephone_number": "503-494-8921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2730 SW Moody Ave",
            "address_2": "Department of Orthodontics",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97201",
            "country_code": "US",
            "telephone_number": "503-494-8921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANIN",
        "first_name": "SIMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "00000",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS0000011186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bartlett",
            "affiliation": "Y",
            "endpointDescription": "Practice email",
            "affiliationName": "Bartlett Pediatric Dentistry",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3071 Kirby Whitten Rd",
            "city": "Bartlett",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381342822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca D Castilo, APRN
• Dione Latrice Catron, LCSW
• Phaniraj Cegu
• Centerwell Health Services USA, LLC (CenterWell Home Health)
• Beverly D Chance, D.PH
• Nicole Leigh Charles
• Steven K Chase, D.P.M.
• Chosen Vessel Ministries
• Chosen Vessel Ministries
• Christian Counseling Center of Bartlett, LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.