Provider Demographics
NPI:1417009366
Name:CHALDARES, DIANE P (DDS)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:P
Last Name:CHALDARES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PELHAM DR
Mailing Address - Street 2:
Mailing Address - City:WAYNEBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-1542
Mailing Address - Country:US
Mailing Address - Phone:540-943-9703
Mailing Address - Fax:540-942-1302
Practice Address - Street 1:101 PELHAM DR
Practice Address - Street 2:
Practice Address - City:WAYNEBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1542
Practice Address - Country:US
Practice Address - Phone:540-943-9703
Practice Address - Fax:540-942-1302
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010058411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice