Individual provider Active NPI

Randy Chaiz

  • General Practice Dentistry
  • Cinnaminson, NJ
National Provider Identifier
1811674336
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI03026600 Issued in NJ
Practice address
1630 Riverton Rd
Cinnaminson, NJ 08077-2343
Phone
(856) 786-2020
NPI assigned
Jun 28, 2023
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI03026600 NJ Primary

Addresses

Primary practice location

1630 Riverton Rd
Cinnaminson, NJ 08077-2343

Mailing address

1630 Riverton Rd
Cinnaminson, NJ 08077-2343
Phone (856) 786-2020

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

LicenseStateTypeSpecialty
22DI03026600NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1811674336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 RIVERTON RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772343",
            "telephone_number": "856-786-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 RIVERTON RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772343",
            "telephone_number": "856-786-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIZ",
        "first_name": "RANDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI03026600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cinnaminson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.