Individual provider Active NPI

Harinderpal Singh Chahal, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Albany, NY
National Provider Identifier
1487742094
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
049440 Issued in NY
Practice address
5 Palisades Dr
Suite 210
Albany, NY 12205-6433
Phone
(518) 348-0634
NPI assigned
Oct 10, 2006
Last updated
Dec 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 23119 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12011777A IN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6853-15 WI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 049440 NY Primary

Addresses

Primary practice location

5 Palisades Dr
Suite 210
Albany, NY 12205-6433

Mailing address

5 Palisades Dr
Suite 210
Albany, NY 12205-6433
Phone (518) 348-0634

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
I20140219000764 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 5496856791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oral Maxillofacial Surgery of the Southern Tier PCGroup PAC ID 0547259459, 3 clinicians

Practice addresses (Care Compare)

451 W Church St
Elmira, NY 14901-2636
Phone (607) 733-3760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011777AINMDOral and Maxillofacial Surgery (Dentist)
6853-15WIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Maxillofacial Surgery of the Southern Tier, PC Oral and Maxillofacial Surgery CurrentSince Oct 3, 2016 Accepting new patients

Locations

451 W Church St
Elmira, NY 14901
Phone (607) 733-3760

451 W Church St
Ste 1
Elmira, NY 14901

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, 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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1487742094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PALISADES DR",
            "address_2": "SUITE 210",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122056433",
            "telephone_number": "518-348-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PALISADES DR",
            "address_2": "SUITE 210",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122056433",
            "telephone_number": "518-348-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAHAL",
        "first_name": "HARINDERPAL",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23119",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12011777A",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "6853-15",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "049440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.