MEDICARE: DR. BRIAN E CHAMBERLAIN DDS, MDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	53-53	NV
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-53	NV

General Provider Information

NPI Number	:	1326261132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN E CHAMBERLAIN DDS, MDS

Provider Business Mailing Address
First Line	:	7090 N DURANGO DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4495
Country	:	US
Telephone Number	:	702-645-5100
Fax Number	:	702-645-6793

Provider Business Practice Location Address
First Line	:	7090 N DURANGO DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4495
Country	:	US
Telephone Number	:	702-645-5100
Fax Number	:	702-645-6793

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	10/05/2022

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Directions to “ DR. BRIAN E CHAMBERLAIN DDS, MDS” Practice Location

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