Provider Demographics
NPI:1225449580
Name:PATRICK PIRKLE & JOSHUA CHAPMAN, DMD, PA
Entity Type:Organization
Organization Name:PATRICK PIRKLE & JOSHUA CHAPMAN, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:VANN
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-388-0088
Mailing Address - Street 1:621 SEBASTIAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-4309
Mailing Address - Country:US
Mailing Address - Phone:772-388-0088
Mailing Address - Fax:772-388-0071
Practice Address - Street 1:621 SEBASTIAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-4309
Practice Address - Country:US
Practice Address - Phone:772-388-0088
Practice Address - Fax:772-388-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16681122300000X
FLDN16421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty