Provider Demographics
NPI:1326261132
Name:CHAMBERLAIN, BRIAN E (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7090 N DURANGO DR STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4495
Mailing Address - Country:US
Mailing Address - Phone:702-645-5100
Mailing Address - Fax:702-645-6793
Practice Address - Street 1:7090 N DURANGO DR STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4495
Practice Address - Country:US
Practice Address - Phone:702-645-5100
Practice Address - Fax:702-645-6793
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV53-531223X0400X
NVS3-531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty