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DR. PAUL WAYNE CHADBOURN D.D.S.
NPI 1912044637
Dentist - General Practice in Blaine, MN

Active since January 31, 2007Opted out of Medicare · through Aug 18, 2027
9120 BALTIMORE ST NE, BLAINE, MN 55449(763) 786-1560(763) 786-4390 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Paul Wayne Chadbourn D.d.s. NPPES

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

DR. PAUL WAYNE CHADBOURN D.D.S. (NPI 1912044637) is an individual general practice provider in Blaine, Minnesota, licensed in Minnesota (8429) and active in the NPI registry since January 2007. He has opted out of Medicare through August 18, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1912044637
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. PAUL WAYNE CHADBOURNCredential: D.D.S.
Location Address9120 BALTIMORE ST NEBlaine, MN 55449-4337
Mailing Address22 Blue Jay LnNorth Oaks, MN 55127-2015 · (651) 490-1225
Phone(763) 786-1560
Fax(763) 786-4390
Sole ProprietorYes
Enumeration DateJanuary 31, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1912044637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · 8429
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
9120 BALTIMORE ST NE, Blaine, MN 55449
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Paul Wayne Chadbourn 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 August 18, 2015 through August 18, 2027.

Opt-Out Effective DateAugust 18, 2015
Opt-Out In Effect ThroughAugust 18, 2027Opt-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 55449 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN HAROLD TROSELIUS D.D.S.
Dentist (General Practice)
9120 BALTIMORE ST NE
BLAINE, MN 55449
Anoka County (763) 786-1560
DR. ANDREW THOMAS CHADBOURN DMD
Dentist
9120 BALTIMORE ST NE
BLAINE, MN 55449
Anoka County (763) 786-1560
DR. GREGORY JOHN POVOLNY D.D.S.
Dentist (General Practice)
9120 BALTIMORE ST NE
BLAINE, MN 55449
Anoka County (763) 786-1560
NORTHPARK DENTAL
Dentist
9120 BALTIMORE ST NE
BLAINE, MN 55449
Anoka County (763) 786-1560

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 Paul Chadbourn's NPI number?

The NPI number for Paul Chadbourn is 1912044637. It was assigned to this individual provider in the NPPES registry on January 31, 2007.

Where is Paul Chadbourn located?

Paul Chadbourn practices at 9120 Baltimore St NE, Blaine, MN 55449. The listed phone number is (763) 786-1560.

What is Paul Chadbourn's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Paul Chadbourn enrolled in Medicare?

No. Paul Chadbourn has opted out of Medicare through August 18, 2027. 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 Paul Chadbourn accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana list Paul Chadbourn 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 Paul Chadbourn was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.