NPIMap

Organization Active NPI

Chestnut Family Dental, LLC

  • Dental Clinic/Center
  • Manchester, NH
National Provider Identifier
1295956944
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3147 Issued in NH
Legal business name
CHESTNUT FAMILY DENTAL, LLC
Practice address
745 Chestnut St
Manchester, NH 03104-3002
Phone
(603) 622-7173
Fax
(603) 668-2709
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen Anne Kenney
Title
Office Manager
Phone
(603) 622-7173

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 3147 NH Primary
Dental Clinic/Center 261QD0000X 3178 NH

Addresses

Primary practice location

745 Chestnut St
Manchester, NH 03104-3002

Mailing address

745 Chestnut St
Manchester, NH 03104-3002
Phone (603) 622-7173

Other identifiers 2

IdentifierTypeStateIssuer
30303489MedicaidNH
30301213MedicaidNH

National Provider Directory

National Provider Directory

Locations

745 Chestnut St
Manchester, NH 03104
Phone (603) 622-7173

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295956944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 CHESTNUT ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031043002",
            "telephone_number": "603-622-7173",
            "fax_number": "603-668-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 CHESTNUT ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031043002",
            "telephone_number": "603-622-7173",
            "fax_number": "603-668-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "603-622-7173"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NH",
            "license": "3147",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NH",
            "license": "3178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30303489",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30301213",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.