Holly Chamberlain, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3215 Issued in OR

Practice address

1800 State St
Salem, OR 97301-4343

Phone

(503) 363-8625

Fax

(503) 363-0027

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holly a Chamberlain DDS LLC

  • General Practice Dentistry
  • Salem, OR
  • NPI 1639606965
  NPD (past) Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629137005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014343",
            "telephone_number": "503-363-8625",
            "fax_number": "503-363-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014343",
            "telephone_number": "503-363-8625",
            "fax_number": "503-363-0027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "858 Commercial St NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973011016",
            "country_code": "US",
            "telephone_number": "503-363-8625",
            "fax_number": "503-363-0027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "HOLLY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D3215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole Cessnun
• CGCG II, Inc
• Preston Wyatt Chadwick, M.D.
• Chakra LLC
• Renata Chalukian, PEER SUPPORT
• Shelley Caitlin Chamberlain, MA,CADCI,QMHP
• Thomas J Chamberlin, MD
• Karen Ann Chambers, MSW, LCSW
• Albert C Chan, PHARMD
• William Warren Chance, M.D.

• General Practice Dentistry in Salem, OR
• Providers in Salem, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.