Provider Demographics
NPI:1265845341
Name:CHEGINI, HOUMAN (DDS)
Entity Type:Individual
Prefix:
First Name:HOUMAN
Middle Name:
Last Name:CHEGINI
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 1:1207 VOLVO PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-7654
Mailing Address - Country:US
Mailing Address - Phone:757-465-8900
Mailing Address - Fax:757-488-7365
Practice Address - Street 1:1207 VOLVO PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-7654
Practice Address - Country:US
Practice Address - Phone:757-465-8900
Practice Address - Fax:757-488-7365
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414453122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist