Provider Demographics
NPI:1417248014
Name:CHI, ALANNA S (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALANNA
Middle Name:S
Last Name:CHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 STATE ST APT 912
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3605
Mailing Address - Country:US
Mailing Address - Phone:954-439-1168
Mailing Address - Fax:
Practice Address - Street 1:921 STATE ST
Practice Address - Street 2:LEVY DENTAL GROUP
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3926
Practice Address - Country:US
Practice Address - Phone:203-865-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010828122300000X
FLDN 19546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist