Provider Demographics
NPI:1487435921
Name:CHAMBERLAIN DENTAL, PLLC
Entity type:Organization
Organization Name:CHAMBERLAIN DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAPOLEON
Authorized Official - Middle Name:CHAMBERLAIN
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:IV
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-991-6392
Mailing Address - Street 1:1222 E MISSOURI AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2922
Mailing Address - Country:US
Mailing Address - Phone:626-991-6392
Mailing Address - Fax:
Practice Address - Street 1:1222 E MISSOURI AVE STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2922
Practice Address - Country:US
Practice Address - Phone:626-991-6392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental