Chester Trent Adams, DMD
Individual provider Active NPI Dentist · Show Low, AZ
NPI 1134579022 · NPPES record last updated Jun 21, 2016
Key facts
- NPI
- 1134579022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D009493 (AZ)
- Practice address
- 51 S White Mountain Rd
Show Low, AZ 85901-6105 - Phone
- (928) 537-1282
- NPI assigned
- Jun 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D009493 | AZ | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D009493 | AZ | Yes |
Addresses
Primary practice location
51 S White Mountain Rd
Show Low, AZ 85901-6105
Mailing address
51 S White Mountain Rd
Show Low, AZ 85901-6105
Phone (928) 537-1282
Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.