Individual provider Active NPI

Eros Santos Chaves, DDS, MS, DMD

  • Periodontics
  • Vero Beach, FL
National Provider Identifier
1972619203
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN 15531 Issued in FL
Practice address
3755 20TH PL
Vero Beach, FL 32960-2302
Phone
(772) 569-0123
Fax
(772) 569-9070
NPI assigned
Aug 21, 2006
Last updated
Oct 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN 15531 FL Primary
Periodontics 1223P0300X 19496 TX

Addresses

Primary practice location

3755 20TH PL
Vero Beach, FL 32960-2302

Mailing address

935 43Rd Ter SW
Vero Beach, FL 32968-4886
Phone (772) 299-4112

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
19496TXMDProfessional Counselor
DN 15531FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Root Dental, PA 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1972619203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 43RD TER SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329684886",
            "telephone_number": "772-299-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 20TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329602302",
            "telephone_number": "772-569-0123",
            "fax_number": "772-569-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVES",
        "first_name": "EROS",
        "middle_name": "SANTOS",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN 15531",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "19496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

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