Provider Demographics
NPI:1427590595
Name:CHAUX & GOMEZ DDS INC
Entity Type:Organization
Organization Name:CHAUX & GOMEZ DDS INC
Other - Org Name:GOOD NEIGHBOR DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANETH
Authorized Official - Middle Name:LUCIA
Authorized Official - Last Name:CHAUX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-644-0437
Mailing Address - Street 1:13637 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5812
Mailing Address - Country:US
Mailing Address - Phone:310-644-0437
Mailing Address - Fax:310-644-0937
Practice Address - Street 1:13637 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5812
Practice Address - Country:US
Practice Address - Phone:310-644-0437
Practice Address - Fax:310-644-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1124239595OtherMEDI-CAL