Active NPI
S Chavis
- Dentist
- Baltimore, MD
National Provider Identifier
1700205010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901021597
- Practice address
- 650 W Baltimore St
Baltimore, MD 21201-1510 - Phone
- (410) 303-6125
- NPI assigned
- Apr 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901021597 | MI | Primary |
Addresses
Primary practice location
650 W Baltimore St
Baltimore, MD 21201-1510
Mailing address
1417 Natalie LN
Apt 308
Ann Arbor, MI 48105-2914
Phone (410) 303-6125
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901021597 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550102400000",
"number": "1700205010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 NATALIE LN",
"address_2": "APT 308",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481052914",
"telephone_number": "410-303-6125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 W BALTIMORE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011510",
"telephone_number": "410-303-6125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIS",
"first_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-15",
"last_updated": "2019-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901021597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.