Provider Demographics
NPI:1316182165
Name:CHICK, JOHN ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:CHICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE
Mailing Address - Street 2:SUITE 1315
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6901
Mailing Address - Country:US
Mailing Address - Phone:301-652-2277
Mailing Address - Fax:301-652-6560
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:SUITE 1315
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6901
Practice Address - Country:US
Practice Address - Phone:301-652-2277
Practice Address - Fax:301-652-6560
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist