Provider Demographics
NPI:1003093642
Name:CHIAKOWSKY, JADY L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JADY
Middle Name:L
Last Name:CHIAKOWSKY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2993 BIRD ROCK RD
Mailing Address - Street 2:
Mailing Address - City:PEBBLE BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93953-2937
Mailing Address - Country:US
Mailing Address - Phone:949-637-5283
Mailing Address - Fax:
Practice Address - Street 1:81 VIA ROBLES
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-6113
Practice Address - Country:US
Practice Address - Phone:831-373-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD105701223X0400X
CA372031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics