Martin V Chaney, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2007 Issued in MS

Practice address

3205 Wisconsin Ave
Vicksburg, MS 39180-5350

Phone

(601) 634-6080

Fax

(601) 634-6081

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Oldenburg Family Dentistry LLC

  • Dental Clinic/Center
  • Vicksburg, MS
  • NPI 1952101784
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821150194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 VIRGINIA RDG",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391807712",
            "telephone_number": "601-634-6080",
            "fax_number": "601-634-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 WISCONSIN AVE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805350",
            "telephone_number": "601-634-6080",
            "fax_number": "601-634-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "MARTIN",
        "middle_name": "V",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00060033",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Mississippi Civic Improvement Association
• Central Mississippi Civic Improvement Association, Inc
• Central Mississippi Medical Clinic PLLC
• Central Mississippi Prevention Services Inc
• Central Mississippi Vascular Care, LLC
• Suzanne Channell, ATC, LAT, MBA
• Kathleen Chappelear, LCSW
• Linda Cheslek
• Michael Chester, PTA
• Susan A Chiarito, MD

• All providers in Vicksburg, MS
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.