Active NPI
David M Chamberlain, DDS
- General Practice Dentistry
- Bonney Lake, WA
National Provider Identifier
1740405620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60904780
- Practice address
- 19657 State Route 410 E
Bonney Lake, WA 98391-5202 - Phone
- (253) 780-7003
- Fax
- (253) 780-7004
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60904780 | WA | Primary |
Addresses
Primary practice location
19657 State Route 410 E
Bonney Lake, WA 98391-5202
Mailing address
19657 State Route 410 E
Bonney Lake, WA 98391-5202
Phone (253) 780-7003
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 362399-9922 | UT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairwood Pedodonticsllc | Current | Accepting new patients | |
| Fairwood Dental LLC | General Practice | Current | Accepting new patients |
| Port Orchard Dental LLC | General Practice | Current | Accepting new patients |
Organizations & group practices 3
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.
-
dba Comfort Dental Fairwood
- General Practice Dentistry
- Renton, WA
- NPI 1639799471
-
dba Comfort Dental Kids Fairwood
- Pediatric Dentistry
- Renton, WA
- NPI 1164197125
-
dba Comfort Dental Port Orchard
- General Practice Dentistry
- Port Orchard, WA
- NPI 1538732144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1740405620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19657 STATE ROUTE 410 E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983915202",
"telephone_number": "253-780-7003",
"fax_number": "253-780-7004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19657 STATE ROUTE 410 E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983915202",
"telephone_number": "253-780-7003",
"fax_number": "253-780-7004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERLAIN",
"first_name": "DAVID",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60904780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.