Randall Wayne Chambers II, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901017043 Issued in MI

Practice address

6200 28TH St SE
Grand Rapids, MI 49546-6930

Phone

(616) 949-4650

Fax

(616) 949-5377

NPI assigned

Aug 1, 2006

Last updated

May 21, 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 2

Medicare fee-for-service enrollment

Enrolled in MI

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

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.

• Randall W. Chambers, DDS, PC

  • Dental Clinic/Center
  • Grand Rapids, MI
  • NPI 1801060702
  Authorized official Same address or phone

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1598772972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466930",
            "telephone_number": "616-949-4650",
            "fax_number": "616-949-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466930",
            "telephone_number": "616-949-4650",
            "fax_number": "616-949-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "RANDALL",
        "middle_name": "WAYNE",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST LICENSE",
            "identifier": "2901017043",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "383605922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerri Chamberlain, LLMSW
• Eileen Chamberlin, LMSW, CAADC
• Christopher M Chambers, MD, PHD
• Jeffrey Chambers
• Jennifer Dawn Chambers
• Frances G Chames, MD
• James A Chamness, MD
• Laura Deann Champion, MD
• Gina Anne Chan, BCBA
• Ho-See Catherine Chan, MD

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.