Champlain Periodontal P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0160002033 Issued in VT

Legal business name

CHAMPLAIN PERIODONTAL P.C.

Practice address

37 Timber LN
South Burlington, VT 05403-5201

Phone

(802) 862-1435

Fax

(802) 864-6998

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian D Huber, D.M.D., M.S.NPI 1689775934

Title

Owner

Phone

(802) 862-1435

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian D Huber, DDS MS

  • Periodontics
  • So Burlington, VT
  • NPI 1689775934
  NPD (past) Authorized official
• Nevin Zablotsky, DMD

  • Periodontics
  • So Burlington, VT
  • NPI 1396846655
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598884850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054035201",
            "telephone_number": "802-862-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054035201",
            "telephone_number": "802-862-1435",
            "fax_number": "802-864-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPLAIN PERIODONTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUBER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-862-1435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VT",
            "license": "0160002033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006633",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CH MH Services (VT), LLC (Charlie Health)
• Bruce Jeffrey Chalmer, PH.D.
• Francis Chamberlain, LADC
• Champlain Dental Group, LTD
• Champlain Eye and Vision PLLC
• Champlain Smile Solutions, PLLC
• Champlain Valley Cardiovascular Associates, PC
• Champlain Valley Neurology
• Champlain Valley Urgent Care, PC
• Gregory C Chan, DDS

• Periodontics in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Periodontics in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.