100 Chiro Dehaven PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

100 CHIRO DEHAVEN PLLC

Practice address

446 Rinehart Rd
Lake Mary, FL 32746-5242

Phone

(616) 826-0275

NPI assigned

Jun 14, 2023

Last updated

Jun 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dorian Eugene Dehaven, DCNPI 1164976536

Title

Chiropractor

Phone

(616) 826-0275

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dorian Dehaven, D.C.

  • Chiropractor
  • Lake Mary, FL
  • NPI 1164976536
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1780368340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15056 BIGNELL DR",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179139",
            "telephone_number": "616-826-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 RINEHART RD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465242",
            "telephone_number": "616-826-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "100 CHIRO DEHAVEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "DEHAVEN",
        "authorized_official_first_name": "DORIAN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "616-826-0275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 710 N Sun Dr Opco LLC (Aviata at Lake Mary)
• 710 North Sun Drive Operations LLC (Lake Mary Health and Rehabilitation Center)
• A Gupta MD PA
• A H VS LLC
• A Helping Hands Physicians Group LLC

• Chiropractor in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.