Wayne S Chanler, DMD,PC

Individual provider Active NPI General Practice Dentistry · Naples, NY

NPI 1124152715 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1124152715
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
032121 (NY)
Practice address
106 N. Main Street
Naples, NY 14512
Phone
(585) 374-6323
Fax
(585) 374-6324
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160422001446 NY Order and Referring Only - Dentist
Practitioner - Dentist
3173822343

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
032121NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne S Chanler, DMD, PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 032121 NY Yes

Addresses

Primary practice location

106 N. Main Street
Naples, NY 14512

Mailing address

PO Box 308
Naples, NY 14512-0308
Phone (585) 374-6323

Other identifiers

IdentifierTypeStateIssuer
00464291MedicaidNY
32121OtherNYCSEA
7710OtherNYBLUE CROSS
5828183OtherNYAETNA

Other providers in Naples, NY

All providers in Naples, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.