Individual provider Active NPI

Robert Tate Chauncey, DMD, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Henderson, NV
National Provider Identifier
1194391995
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
S3-369 Issued in NV
Practice address
1465 E Lake Mead Pkwy Ste 140
Henderson, NV 89015-4631
Phone
(702) 330-4542
NPI assigned
Jun 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X S3-369 NV Primary

Addresses

Primary practice location

1465 E Lake Mead Pkwy Ste 140
Henderson, NV 89015-4631

Mailing address

172 Brighton Hills Ave
Henderson, NV 89002-0527
Phone (702) 306-1830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S3-369NVMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
R. Tate Chauncey DMD MSD, PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Dec 24, 2023 Accepting new patients
Designer Smiles of Al, Inc. Orthodontics and Dentofacial Orthopedics PastSince Jun 1, 2021 Accepting new patients

Locations

1465 E Lake Mead Pkwy
Ste 140
Henderson, NV 89015
Phone (702) 306-1830

Organizations & group practices 2

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1194391995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 BRIGHTON HILLS AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890020527",
            "telephone_number": "702-306-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 E LAKE MEAD PKWY STE 140",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890154631",
            "telephone_number": "702-330-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUNCEY",
        "first_name": "ROBERT",
        "middle_name": "TATE",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S3-369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.