Provider Demographics
NPI:1447598917
Name:CHAUDHARI, GIRISHKUMAR (DDS,MPH)
Entity Type:Individual
Prefix:
First Name:GIRISHKUMAR
Middle Name:
Last Name:CHAUDHARI
Suffix:
Gender:M
Credentials:DDS,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 RIDGEPOINT DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3569
Mailing Address - Country:US
Mailing Address - Phone:682-227-5003
Mailing Address - Fax:
Practice Address - Street 1:3030 LBJ FWY
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7781
Practice Address - Country:US
Practice Address - Phone:972-444-8888
Practice Address - Fax:972-488-8848
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX286241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice