D Craig Chamberlain, DDS
Individual provider Active NPI Dentist · Wendover, UT
NPI 1376575613 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376575613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 341527 (UT)
- Practice address
- 399 N Aria Blvd
Wendover, UT 84083-0625 - Phone
- (435) 665-2962
- Fax
- (435) 665-7525
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 341527 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wendover Dental Care PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 341527 | UT | Yes |
Addresses
Primary practice location
399 N Aria Blvd
Wendover, UT 84083-0625
Mailing address
PO Box 625
399 Aria Blvd
Wendover, UT 84083-0625
Phone (435) 665-2962
Other providers in Wendover, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.