Provider Demographics
NPI:1417011347
Name:CHAMORRO-EZZIE, MONICA M (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:M
Last Name:CHAMORRO-EZZIE
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:M
Other - Last Name:CHAMORRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:4422 OSBY DR.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096
Mailing Address - Country:US
Mailing Address - Phone:713-429-5500
Mailing Address - Fax:
Practice Address - Street 1:9701 N SAM HOUSTON PKWY E
Practice Address - Street 2:STE. 280
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4636
Practice Address - Country:US
Practice Address - Phone:281-491-0069
Practice Address - Fax:281-491-0083
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70221223E0200X
TX225991223E0200X
VA04014121271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics