1. Home
  2. Directory
  3. Washington
  4. Puyallup
  5. Dentist
  6. NPI Profile

DR. GUILLERMO ENRIQUE CHACON D.D.S.
NPI 1619047511
Dentist - Oral and Maxillofacial Surgery in Puyallup, WA

Active since November 08, 2006Opted out of Medicare · through Sep 17, 2026
2910 S MERIDIAN, SUITE 120, PUYALLUP, WA 98373(253) 445-0022(253) 445-0979 Get Directions Write a Review

NPPES record last updated: April 10, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Guillermo Enrique Chacon D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GUILLERMO ENRIQUE CHACON D.D.S. (NPI 1619047511) is an individual oral and maxillofacial surgery provider in Puyallup, Washington, licensed in Washington (DE 60063175) and active in the NPI registry since November 2006. He has opted out of Medicare through September 17, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1619047511
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. GUILLERMO ENRIQUE CHACONCredential: D.D.S.
Location Address2910 S MERIDIAN, SUITE 120Puyallup, WA 98373-1585
Mailing Address2910 S Meridian, Suite 120Puyallup, WA 98373-1585 · (253) 445-0022 · Fax (253) 445-0979
Phone(253) 445-0022
Fax(253) 445-0979
Sole ProprietorYes
Enumeration DateNovember 8, 2006
Last NPPES UpdateApril 10, 2017
✔ NPI 1619047511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in WA · DE 60063175
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2910 S MERIDIAN, Puyallup, WA 98373
Open in Google Maps ↗

Other Identifiers 5

Other311203750028OH · Caresource
Other2237985OH · Bcmh
OtherCH4046621WA · Medicare Id Type Unspecified Provider
Medicare UPINU84561WA
Medicaid2237985WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Guillermo Enrique Chacon D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 17, 2020 through September 17, 2026.

Opt-Out Effective DateSeptember 17, 2020
Opt-Out In Effect ThroughSeptember 17, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98373 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Guillermo Chacon's NPI number?

The NPI number for Guillermo Chacon is 1619047511. It was assigned to this individual provider in the NPPES registry on November 8, 2006.

Where is Guillermo Chacon located?

Guillermo Chacon practices at 2910 S Meridian Suite 120, Puyallup, WA 98373. The listed phone number is (253) 445-0022.

What is Guillermo Chacon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Guillermo Chacon enrolled in Medicare?

No. Guillermo Chacon has opted out of Medicare through September 17, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Guillermo Chacon accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Guillermo Chacon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Guillermo Chacon was last updated on April 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.