Individual provider Active NPI

Dale Marshall Charnas, D.D.S.

  • General Practice Dentistry
  • Dearborn, MI
National Provider Identifier
1588779995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10405 Issued in MI
Practice address
25001 Ford Rd
Dearborn, MI 48128-1002
Phone
(313) 563-8280
Fax
(313) 563-4677
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10405 MI Primary

Addresses

Primary practice location

25001 Ford Rd
Dearborn, MI 48128-1002

Mailing address

25001 Ford Rd
Dearborn, MI 48128-1002
Phone (313) 563-8280

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10405MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588779995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25001 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281002",
            "telephone_number": "313-563-8280",
            "fax_number": "313-563-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25001 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281002",
            "telephone_number": "313-563-8280",
            "fax_number": "313-563-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNAS",
        "first_name": "DALE",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "10405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.