Organization Active NPI

Richard E. Chodroff, D.M.D.

  • Periodontics
  • Wilmington, DE
National Provider Identifier
1790707289
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
914 Issued in DE
Legal business name
RICHARD E. CHODROFF, D.M.D.
Practice address
3105 Limestone Rd
Suite 203
Wilmington, DE 19808-2147
Phone
(302) 995-6979
Fax
(302) 995-6645
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard E. Chodroff, D.M.D.
Title
Owner
Phone
(302) 995-6979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 914 DE Primary

Addresses

Primary practice location

3105 Limestone Rd
Suite 203
Wilmington, DE 19808-2147

Mailing address

3105 Limestone Rd
Suite 203
Wilmington, DE 19808-2147
Phone (302) 995-6979

Other identifiers 1

IdentifierTypeStateIssuer
0000881108MedicaidDE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790707289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 LIMESTONE RD",
            "address_2": "SUITE 203",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198082147",
            "telephone_number": "302-995-6979",
            "fax_number": "302-995-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 LIMESTONE RD",
            "address_2": "SUITE 203",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198082147",
            "telephone_number": "302-995-6979",
            "fax_number": "302-995-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E. CHODROFF, D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHODROFF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-995-6979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "DE",
            "license": "914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000881108",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.