Collin Jackson Chavous, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN26407 Issued in FL

Practice address

657 Tamiami TRL S
Venice, FL 34285-3237

Phone

(941) 488-7230

NPI assigned

May 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dynamic Dental Health Associates of Florida, PA

  • General Practice Dentistry
  • Venice, FL
  • NPI 1164731857
  NPD (past)
• Palmetto Dental Center LLC

  • General Practice Dentistry
  • Palmetto, FL
  • NPI 1285024265
  NPD (past)

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1528680451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5727 FRENCH CREEK CT",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342225203",
            "telephone_number": "864-901-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853237",
            "telephone_number": "941-488-7230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 7th St W",
            "address_purpose": "LOCATION",
            "city": "Palmetto",
            "state": "FL",
            "postal_code": "342215206",
            "country_code": "US",
            "telephone_number": "941-729-6883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4800 Lakewood Ranch Blvd",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342114953",
            "country_code": "US",
            "telephone_number": "941-405-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVOUS",
        "first_name": "COLLIN",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2022-04-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Charette, MD
• Charles a Suleskey DPM PA
• Charles W. Schmidt DDS, PA
• Lorraine Charles-Hosten
• Alexandra Charles
• Dana B Chaykin-Glover, DO
• Joseph E Chebli, M.D. F.A.C.S
• Hui-Chin Chen
• Linda Margaret Chlebina, PT
• Lorraine Sheryl Cho Chung Hing, M.D.

• Dentist in Venice, FL
• Providers in Venice, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.