Active NPI
John E Chaney, DDS
- Prosthodontics
- McDonough, GA
National Provider Identifier
1508937384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 011625
- Practice address
- 2330 Patrick Henry Pkwy
Suite 300
McDonough, GA 30253 - Phone
- (770) 474-1239
- Fax
- (770) 474-1242
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 011625 | GA | Primary |
Addresses
Primary practice location
2330 Patrick Henry Pkwy
Suite 300
McDonough, GA 30253
Mailing address
2330 Patrick Henry Pkwy
Suite 300
McDonough, GA 30253
Phone (770) 474-1239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 22, 2016 through Apr 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011625 | GA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1508937384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 PATRICK HENRY PKWY",
"address_2": "SUITE 300",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "30253",
"telephone_number": "770-474-1239",
"fax_number": "770-474-1242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 PATRICK HENRY PKWY",
"address_2": "SUITE 300",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "30253",
"telephone_number": "770-474-1239",
"fax_number": "770-474-1242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANEY",
"first_name": "JOHN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "GA",
"license": "011625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
- Central Georgia Adrenal and Reproductive Endocrinology
- Michelle Lynn Chambers-Lewis, D.C.
- Shirley Tate Chambers, LPC
- Champion Health Management LLC
- Stephanie E Chandler, CRNP
- Kelsie V Chaney
- Chapman Chiropractic Center, Inc.
- Monique Chappell
- Charis Counseling and Educational Services
- Beracca Nathanaelle Charles
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.