William Doug Chambers, D.D.S.. PA
Individual provider Active NPI General Practice Dentistry · Wichita, KS
NPI 1124235684 · NPPES record last updated Jan 24, 2011
Key facts
- NPI
- 1124235684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5472 (KS)
- Practice address
- 9339 E. 21St St. North
Wichita, KS 67206-2971 - Phone
- (316) 630-9339
- Fax
- (316) 630-9353
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180423001124 | KS | Order and Referring Only - Dentist |
8628331808 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5472 | KS | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5472 | KS | Yes |
Addresses
Primary practice location
9339 E. 21St St. North
Wichita, KS 67206-2971
Mailing address
9339 E, 21St St. North
Wichita, KS 67206-2971
Phone (316) 630-9339
Other providers in Wichita, KS
- Ushasri Challa
- Phillip D Challans
- Chris Chamberlain
- Jennifer Marie Chambers Daney
- Morghan Maysel Chambers
- Joe Champion
- Prince Chan
- Wan-CHI Chan
- Karen Mauri Chandler
- Mekhia Chandler
All providers in Wichita, KS · General Practice Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.