Active NPI
Ronald Antonio Chinchilla, D.M.D.
- Dentist
- Saint Charles, MO
National Provider Identifier
1205675337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2024017652
- Practice address
- 1050 S 5TH St
Saint Charles, MO 63301-2419 - Phone
- (314) 200-3880
- NPI assigned
- May 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2024017652 | MO | Primary |
Addresses
Primary practice location
1050 S 5TH St
Saint Charles, MO 63301-2419
Mailing address
16735 Chesterfield Manor Dr
Chesterfield, MO 63005-1643
Phone (786) 525-5691
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2024017652 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1205675337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16735 CHESTERFIELD MANOR DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630051643",
"telephone_number": "786-525-5691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 S 5TH ST",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012419",
"telephone_number": "314-200-3880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHINCHILLA",
"first_name": "RONALD",
"middle_name": "ANTONIO",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2024017652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.