Individual provider Active NPI

Chad Michael Whiting, DDS

  • General Practice Dentistry
  • Cedar Park, TX
National Provider Identifier
1144355629
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31830 Issued in TX
Practice address
12171 W Parmer LN Ste 101
Cedar Park, TX 78613-7362
Phone
(512) 528-8900
Fax
(512) 528-8903
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31830 TX Primary
General Practice Dentistry 1223G0001X 5904 AZ

Addresses

Primary practice location

12171 W Parmer LN Ste 101
Cedar Park, TX 78613-7362

Mailing address

12171 W Parmer LN Ste 101
Cedar Park, TX 78613-7362
Phone (512) 528-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150819007731 AZ Order and Referring Only - DentistPractitioner - Dentist 3577875335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31830TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
CRD Partnership PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1144355629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 W PARMER LN STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137362",
            "telephone_number": "512-528-8900",
            "fax_number": "512-528-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12171 W PARMER LN STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137362",
            "telephone_number": "512-528-8900",
            "fax_number": "512-528-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31830",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.