Provider Demographics
NPI:1023192648
Name:CHIRA, DMD, DARA (DARA CHIRA, DMD)
Entity Type:Individual
Prefix:DR
First Name:DARA
Middle Name:
Last Name:CHIRA, DMD
Suffix:
Gender:F
Credentials:DARA CHIRA, DMD
Other - Prefix:DR
Other - First Name:DARA
Other - Middle Name:
Other - Last Name:CHIRA, DMD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DARA CHIRA, DMD
Mailing Address - Street 1:1073 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408
Mailing Address - Country:US
Mailing Address - Phone:802-652-1010
Mailing Address - Fax:802-652-0062
Practice Address - Street 1:1073 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-2709
Practice Address - Country:US
Practice Address - Phone:802-652-1010
Practice Address - Fax:802-652-0062
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-00020601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVT 016-0002060OtherORTHODONTICS