Individual provider Active NPI

Camille Chiques, DMD

  • Dental Anesthesiology
  • New York, NY
National Provider Identifier
1417189853
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
001176 Issued in NY
Practice address
447 E 78TH St Apt 2B
New York, NY 10075-1652
Phone
(787) 370-8875
NPI assigned
Aug 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Anesthesiology 1223D0004X 001176 NY Primary
Dentist 122300000X 054601 NY

Addresses

Primary practice location

447 E 78TH St Apt 2B
New York, NY 10075-1652

Mailing address

447 E 78TH St Apt 2B
New York, NY 10075-1652
Phone (787) 370-8875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150827000485 NY Practitioner - Oral Surgery 7810203403 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054601NYMDDentist
001176NYMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Heights Dental Services P.C. Dentist CurrentSince Jul 13, 2015 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1417189853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 E 78TH ST APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751652",
            "telephone_number": "787-370-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 E 78TH ST APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751652",
            "telephone_number": "787-370-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIQUES",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NY",
            "license": "001176",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.