Provider Demographics
NPI:1487224788
Name:CHUKHMAN, ADAM (DDS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CHUKHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26326 CITRUS ST
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4955
Mailing Address - Country:US
Mailing Address - Phone:661-231-5768
Mailing Address - Fax:661-244-0014
Practice Address - Street 1:26326 CITRUS ST
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-9135
Practice Address - Country:US
Practice Address - Phone:661-255-6500
Practice Address - Fax:661-244-0014
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1063391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice