Provider Demographics
NPI:1164715363
Name:CHAVEZ, JEAN-PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN-PAUL
Middle Name:
Last Name:CHAVEZ
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 1:11928 SW 74TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3716
Mailing Address - Country:US
Mailing Address - Phone:305-798-1157
Mailing Address - Fax:
Practice Address - Street 1:555 BILTMORE WAY
Practice Address - Street 2:SUITE #102
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5757
Practice Address - Country:US
Practice Address - Phone:305-444-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN192671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice