Champion Dentistry Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHAMPION DENTISTRY INC

Practice address

1172 N 63Rd St
Philadelphia, PA 19151-3208

Phone

(215) 473-4717

NPI assigned

Jan 15, 2021

Organization subpart

No

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

Authorized official

Name

Charles W Champion Jr., DDSNPI 1841458932

Title

Owner

Phone

(215) 473-4717

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Champion Jr.

  • Dentist
  • Philadelphia, PA
  • NPI 1841458932
  NPD Authorized official

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1457940272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 N 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191513208",
            "telephone_number": "215-473-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 N 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191513208",
            "telephone_number": "215-473-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "CHAMPION",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-473-4717",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Day Chambers
• Susan L Chambers, CRNP
• Christina L Chambley, PA-C
• Robert Bryan Chambliss Jr., MD
• Sydney Chambule
• Allen F. Champion, DDS
• Charles Champion Jr.
• Champions Home Care Solutions LLC
• Wichana Chamroonrat, MD
• Dalila Chamseddine, DMD

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.