Provider Demographics
NPI:1467125682
Name:CHIRA, ANDREEA VANITA
Entity Type:Individual
Prefix:DR
First Name:ANDREEA
Middle Name:VANITA
Last Name:CHIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 TOWNE PARK CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4661
Mailing Address - Country:US
Mailing Address - Phone:678-860-1737
Mailing Address - Fax:
Practice Address - Street 1:1531 TOWNE PARK CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4661
Practice Address - Country:US
Practice Address - Phone:678-860-1737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122339122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist