Provider Demographics
NPI:1063700599
Name:CHARLAND, JAMIE (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:CHARLAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 LONG POND DR
Mailing Address - Street 2:APT #187
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-6898
Mailing Address - Country:US
Mailing Address - Phone:518-281-4504
Mailing Address - Fax:
Practice Address - Street 1:833 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3103
Practice Address - Country:US
Practice Address - Phone:518-374-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0555051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice