Active NPI
Jack Ronald Chambers II, DDS
- General Practice Dentistry
- Charles Town, WV
National Provider Identifier
1366629677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2724
- Practice address
- 201 Augustine Avenue
Charles Town, WV 25414 - Phone
- (304) 725-7044
- Fax
- (304) 724-5299
- NPI assigned
- Jan 29, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2724 | WV | Primary |
Addresses
Primary practice location
201 Augustine Avenue
Charles Town, WV 25414
Mailing address
PO Box 879
Ranson, WV 25438
Phone (304) 725-7044
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1366629677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 879",
"city": "RANSON",
"state": "WV",
"postal_code": "25438",
"telephone_number": "304-725-7044",
"fax_number": "304-724-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 AUGUSTINE AVENUE",
"city": "CHARLES TOWN",
"state": "WV",
"postal_code": "25414",
"telephone_number": "304-725-7044",
"fax_number": "304-724-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERS",
"first_name": "JACK",
"middle_name": "RONALD",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-29",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "2724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charles Town, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.