Active NPI
Chinmay Dave
- General Practice Dentistry
- Keller, TX
National Provider Identifier
1881601458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 20905
- Practice address
- 900 S Main St Ste 360
Keller, TX 76248-7024 - Phone
- (817) 740-0045
- NPI assigned
- Aug 3, 2006
- 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 | 20905 | TX | Primary |
Addresses
Primary practice location
900 S Main St Ste 360
Keller, TX 76248-7024
Mailing address
403 Stockton Dr
Southlake, TX 76092-2229
Phone (817) 430-6334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150812007014 | TX | Order and Referring Only - Dentist | 6305151960 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentistry for Life, PA | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Keller, TX
- NPI 1841652799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881601458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 STOCKTON DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760922229",
"telephone_number": "817-430-6334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S MAIN ST STE 360",
"city": "KELLER",
"state": "TX",
"postal_code": "762487024",
"telephone_number": "817-740-0045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVE",
"first_name": "CHINMAY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "20905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keller, TX
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.