Chandravadan Pancholi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901016165 Issued in MI

Practice address

29753 Hoover Rd
B
Warren, MI 48093-8900

Phone

(586) 573-0011

NPI assigned

May 5, 2006

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

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

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.

• Detroit - Gratiot P.C.

  • Dentist
  • Detroit, MI
  • NPI 1841473568
  NPD (past)
• Gentle Dental Gratiot Ave PLLC

  • Dentist
  • Detroit, MI
  • NPI 1811012826
  NPD (past)
• Gentle Dental Warren PLLC

  • Dentist
  • Warren, MI
  • NPI 1568587491
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1639127384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29753 HOOVER RD",
            "address_2": "B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938900",
            "telephone_number": "586-573-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29753 HOOVER RD",
            "address_2": "B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938900",
            "telephone_number": "586-573-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHOLI",
        "first_name": "CHANDRAVADAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie M Paluda, MD
• Pamela L. Tomaszycki, D.C.
• Pamper Little Me LLC
• Soumya Venkata Panchagnula
• Siraj Panchbhaiya, D.P.M.
• Priyanka Pandey, DO
• Neha Hasmukhlal Pandya, RPT
• Shardul Harendra Pandya, RPT
• Jessica Paneccasio
• Percival Pangilinan, MD

• Dentist in Warren, MI
• Providers in Warren, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.