Chuck Chambers DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12005 Issued in GA

Legal business name

CHUCK CHAMBERS DMD

Practice address

2105 Elder Mill Rd
Watkinsville, GA 30677-3356

Phone

(706) 338-8962

NPI assigned

Jul 20, 2006

Reactivated

Aug 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles M Chambers Jr., DMD

Title

Owner

Phone

(706) 338-8962

Specialties & licenses 1

Addresses

Other names 1

• Mobley and Chambers Dental, LLC Former legal business name

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1740200344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 ELDER MILL RD",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306773356",
            "telephone_number": "706-338-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 ELDER MILL RD",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306773356",
            "telephone_number": "706-338-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUCK CHAMBERS DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-05-09",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-338-8962",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "12005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobley and Chambers Dental, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dentist in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.