Douglas Chadwick Church, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

54479 Issued in CA

Practice address

6000 Fairway Dr Ste 15
Rocklin, CA 95677-4246

Phone

(916) 632-3650

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dchurch@direct.westerndental.com

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1992852818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 FAIRWAY DR STE 15",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956774246",
            "telephone_number": "916-632-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 FAIRWAY DR STE 15",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956774246",
            "telephone_number": "916-632-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "DOUGLAS",
        "middle_name": "CHADWICK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "54479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jin Young Choi
• Saie Yoin Choi
• Sheri Chong, OTR/L, IMC, SIPT CER
• Julie Ann Christensen, L.M.F.T.
• Nathanael Lee Christensen
• Hope A Chylewski
• Bryan Cicero
• City of Rocklin
• Cindy Lynn Claflin, LPCC
• Brian Clark

• Orthodontics and Dentofacial Orthopedics Dentistry in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.

Verify at the official NPI Registry.