Provider Demographics
NPI:1447208012
Name:CHANDLER, IRINA P (DDS)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:P
Last Name:CHANDLER
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:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:VA
Mailing Address - Zip Code:22572-0217
Mailing Address - Country:US
Mailing Address - Phone:804-333-0226
Mailing Address - Fax:804-333-6656
Practice Address - Street 1:253 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572
Practice Address - Country:US
Practice Address - Phone:804-333-0226
Practice Address - Fax:804-333-6656
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist