Jay Bennett Chilson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12011390A Issued in IN

Practice address

3487 Central Ave
Riverside, CA 92506-2115

Phone

(951) 369-1001

NPI assigned

Jan 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083945372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3487 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062115",
            "telephone_number": "951-369-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3487 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062115",
            "telephone_number": "951-369-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1547 Ohio Ave",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460161917",
            "country_code": "US",
            "telephone_number": "765-641-0255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILSON",
        "first_name": "JAY",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011390A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Childnet Youth and Family Services, Inc.
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• Donald Richard Childs, MD
• Jacquelynne Celeste Childs, M.F.T.
• Michael Sywe-Yung Chin, M.D.
• Samuel Chin, M.D.
• Wesley Chin, DO
• Maria Petronila Chinaka, PHARM.D.
• Christian Chinchilla

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.