Individual provider Active NPI

Nathan J Chronister, DDS

  • General Practice Dentistry
  • Placerville, CA
National Provider Identifier
1396122974
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS105815 Issued in CA
Practice address
5168 Honpie Rd
Placerville, CA 95667-8682
Phone
(530) 387-4975
NPI assigned
May 2, 2015
Last updated
May 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS105815 CA Primary

Addresses

Primary practice location

5168 Honpie Rd
Placerville, CA 95667-8682

Mailing address

5168 Honpie Rd
Placerville, CA 95667-8682
Phone (530) 387-4975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260615001656 CA Practitioner - Dentist 6507144532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

210 N Broadway Ave
Miller, SD 57362-1414

PO Box
Suite 1340
Shingle Springs, CA 95682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS105815CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Family Dental, PLLC General Practice PastSince Jul 24, 2012 Accepting new patients
Rodgers and Ghazal Dental Corporation General Practice PastSince Nov 7, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1396122974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5168 HONPIE RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678682",
            "telephone_number": "530-387-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5168 HONPIE RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678682",
            "telephone_number": "530-387-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRONISTER",
        "first_name": "NATHAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-02",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS105815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.