Provider Demographics
NPI:1093210205
Name:CHUMPITAZ, FRANCISCO VICENTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:VICENTE
Last Name:CHUMPITAZ
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 1:9962 ALOMA BEND LN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6197
Mailing Address - Country:US
Mailing Address - Phone:201-284-2806
Mailing Address - Fax:
Practice Address - Street 1:380B SEMORAN COMMERCE PL STE 204
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4670
Practice Address - Country:US
Practice Address - Phone:201-284-2806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25133122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist