Active NPI
Georgene Bernice Chase, DDS
- Dentist
- Mad River, CA
National Provider Identifier
1922110337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39138
- Practice address
- 321 Van Duzen Rd
Mad River, CA 95526-9508 - Phone
- (707) 574-6616
- Fax
- (707) 574-6623
- NPI assigned
- Aug 31, 2006
- Last updated
- Oct 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2676 | NV | |
| Dentist | 122300000X | 39138 | CA | Primary |
Addresses
Primary practice location
321 Van Duzen Rd
Mad River, CA 95526-9508
Mailing address
PO Box 4
Mad River, CA 95552-0004
Phone (707) 574-6616
Other practice location 1
100 Horseshoe Lane
Weaverville, CA 96093-0960
Phone (530) 623-8888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2676 | NV | MD | Pulmonary Disease Physician |
| 39138 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smilerestore | Dentist | Current | Accepting new patients |
| The Wecare Group, Inc. | Past | Accepting new patients | |
| Frederick Reese Carlin Jr DDS Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Reno, NV
- NPI 1144827767
-
- General Practice Dentistry
- Weaverville, CA
- NPI 1639307465
-
dba WeCare at Trinity Dental Center
- Federally Qualified Health Center (FQHC)
- Weaverville, CA
- NPI 1255898953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1922110337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4",
"city": "MAD RIVER",
"state": "CA",
"postal_code": "955520004",
"telephone_number": "707-574-6616",
"fax_number": "707-574-6623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 VAN DUZEN RD",
"city": "MAD RIVER",
"state": "CA",
"postal_code": "955269508",
"telephone_number": "707-574-6616",
"fax_number": "707-574-6623"
}
],
"practiceLocations": [
{
"address_1": "100 Horseshoe Lane",
"address_purpose": "LOCATION",
"city": "Weaverville",
"state": "CA",
"postal_code": "960930960",
"country_code": "US",
"telephone_number": "530-623-8888",
"fax_number": "530-623-8887",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHASE",
"first_name": "GEORGENE",
"middle_name": "BERNICE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "2676",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "39138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mad River, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.