Diane P Chaldares, DDS
Individual provider Active NPI General Practice Dentistry · Wayneboro, VA
NPI 1417009366 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1417009366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401005841 (VA)
- Practice address
- 101 Pelham Dr
Wayneboro, VA 22980-1542 - Phone
- (540) 943-9703
- Fax
- (540) 942-1302
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- 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 |
|---|---|---|---|
| 0401005841 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James W Willis V DDS PLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401005841 | VA | Yes |
Addresses
Primary practice location
101 Pelham Dr
Wayneboro, VA 22980-1542
Mailing address
101 Pelham Dr
Wayneboro, VA 22980-1542
Phone (540) 943-9703
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.