Omar Chahbandar

Primary specialty

DentistTaxonomy code 122300000X

License

DEN03275 Issued in RI

Practice address

1 River St
Wakefield, RI 02879-3214

Phone

(401) 783-5646

Fax

(401) 284-2081

NPI assigned

Jul 3, 2015

Last updated

Jul 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435881600000",
    "number": "1588047955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVER ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVER ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793214",
            "telephone_number": "401-783-5646",
            "fax_number": "401-284-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAHBANDAR",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-03",
        "last_updated": "2015-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN03275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH02580",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassondra Marie Catlow
• William Vincent Catone, PHD
• Kristen Cavaco, M.S. DPT
• Michael C. Cerullo Jr., MS, LMHC
• CH Specialty Services Ri LLC
• CHI Y Chan, DVM
• Mitchell Chan, PHARM.D
• Charbonneau Dental, LTD
• Gaetan Donald Charbonneau, DMD
• Nicholas Charbonneau

• Dentist in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Dentist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.