Individual provider Active NPI

Dipak Chaudhari, DDS

  • Dentist
  • Liverpool, NY
National Provider Identifier
1710313697
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-024085 Issued in OH
Practice address
4148 Balboa Dr
Liverpool, NY 13090-1638
Phone
(310) 621-4466
NPI assigned
Sep 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-024085 OH Primary

Addresses

Primary practice location

4148 Balboa Dr
Liverpool, NY 13090-1638

Mailing address

4148 Balboa Dr
Liverpool, NY 13090-1638
Phone (310) 621-4466

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

LicenseStateTypeSpecialty
30-024085OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1710313697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4148 BALBOA DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901638",
            "telephone_number": "310-621-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4148 BALBOA DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901638",
            "telephone_number": "310-621-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHARI",
        "first_name": "DIPAK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.