Provider Demographics
NPI:1003223116
Name:CHAUDHRY, JAVAID (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAVAID
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-8509
Mailing Address - Country:US
Mailing Address - Phone:206-930-6624
Mailing Address - Fax:
Practice Address - Street 1:761 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-8509
Practice Address - Country:US
Practice Address - Phone:206-930-6624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604864261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice