Provider Demographics
NPI:1235466095
Name:CHHABRA, VINOD (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:
Last Name:CHHABRA
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 1:2 ALFRED CIR
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1605
Mailing Address - Country:US
Mailing Address - Phone:631-447-2771
Mailing Address - Fax:
Practice Address - Street 1:2 ALFRED CIR
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1605
Practice Address - Country:US
Practice Address - Phone:631-447-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0396871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice