Provider Demographics
NPI:1093703431
Name:CHHATRIWALA, TARANA H (DDS)
Entity Type:Individual
Prefix:
First Name:TARANA
Middle Name:H
Last Name:CHHATRIWALA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 UNIVERSITY OAKS STE 770
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2443
Mailing Address - Country:US
Mailing Address - Phone:512-579-0069
Mailing Address - Fax:
Practice Address - Street 1:2119 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3106
Practice Address - Country:US
Practice Address - Phone:860-482-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009605122300000X
TX313801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist