Dorian Dehaven, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH-14648 Issued in FL

Practice address

446 Rinehart Rd
Lake Mary, FL 32746-5242

Phone

(616) 826-0275

NPI assigned

Aug 15, 2016

Reactivated

Aug 12, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 100 Chiro Dehaven PLLC

  • Chiropractor
  • Lake Mary, FL
  • NPI 1780368340
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1164976536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 RINEHART RD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465242",
            "telephone_number": "616-826-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 RINEHART RD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465242",
            "telephone_number": "616-826-0275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10990 Chicago Dr",
            "address_purpose": "LOCATION",
            "city": "Zeeland",
            "state": "MI",
            "postal_code": "494648100",
            "country_code": "US",
            "telephone_number": "616-546-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "DORIAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-15",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "deactivation_date": "2024-06-14",
        "reactivation_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010481",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-14648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.