Provider Demographics
NPI:1114342631
Name:VENU M. CHIMMIRI, DDS, LLC
Entity Type:Organization
Organization Name:VENU M. CHIMMIRI, DDS, LLC
Other - Org Name:MERIDEN DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VENU
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHIMMIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-235-3539
Mailing Address - Street 1:35 PLEASANT ST
Mailing Address - Street 2:#2D
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-5786
Mailing Address - Country:US
Mailing Address - Phone:203-235-3539
Mailing Address - Fax:
Practice Address - Street 1:35 PLEASANT ST
Practice Address - Street 2:#2D
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-5786
Practice Address - Country:US
Practice Address - Phone:203-235-3539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty