Blake Chandler, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4002 Issued in AR

Practice address

7409 Alcoa Rd Ste 5
Bryant, AR 72022-6216

Phone

(602) 430-0106

NPI assigned

May 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459036800000",
    "number": "1235188012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 STONEYBROOK DR",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720228300",
            "telephone_number": "602-430-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 ALCOA RD STE 5",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720226216",
            "telephone_number": "602-430-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "BLAKE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2016-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "4002",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "30776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235188012",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "721359",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center for Regenerative Medicine PA
• Central Arkansas Family Practice
• Central Arkansas Treatment Services, LLC
• Central Arkansas Vision Care, P.a.
• Leslie Carol Chambers, APRN
• Anna Chapdelaine, APRN
• Jamie Charleville, PTA
• Asia Alandrea Chatman
• Lillian Cheak, RDN
• Jamie Cheek

• Pediatric Dentistry in Bryant, AR
• Providers in Bryant, AR by specialty
• Pediatric Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2016; 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.