Individual provider Active NPI

Charles Hambleton, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pasadena, CA
National Provider Identifier
1588399620
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DDS107465 Issued in CA
Practice address
200 S Oak Knoll Ave
Pasadena, CA 91101-7900
Phone
(626) 795-0634
NPI assigned
Jul 21, 2022
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DDS107465 CA Primary

Addresses

Primary practice location

200 S Oak Knoll Ave
Pasadena, CA 91101-7900

Mailing address

200 S Oak Knoll Ave
Pasadena, CA 91101-7900
Phone (626) 260-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107465CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a Da Re DDS Dentist PastSince Jul 24, 2022 Accepting new patients

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1588399620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S OAK KNOLL AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911017900",
            "telephone_number": "626-260-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S OAK KNOLL AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911017900",
            "telephone_number": "626-795-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLETON",
        "first_name": "CHARLES",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS107465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.