Individual provider Active NPI

Jayson A. Chalmers, D.D.S.

  • Dentist
  • Sacramento, CA
National Provider Identifier
1184752578
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51468 Issued in CA
Practice address
1820 Professional Dr
Suite 5
Sacramento, CA 95825-2120
Phone
(916) 483-8182
Fax
(916) 483-8187
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 51468 CA Primary

Addresses

Primary practice location

1820 Professional Dr
Suite 5
Sacramento, CA 95825-2120

Mailing address

1820 Professional Dr
Suite 5
Sacramento, CA 95825-2120
Phone (916) 483-8182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160505002004 CA Order and Referring Only - DentistPractitioner - Dentist 8921307364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51468CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1184752578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 PROFESSIONAL DR",
            "address_2": "SUITE 5",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252120",
            "telephone_number": "916-483-8182",
            "fax_number": "916-483-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 PROFESSIONAL DR",
            "address_2": "SUITE 5",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252120",
            "telephone_number": "916-483-8182",
            "fax_number": "916-483-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALMERS",
        "first_name": "JAYSON",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.