Provider Demographics
NPI:1497112395
Name:IYER, CHANDRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:
Last Name:IYER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E 23RD ST
Mailing Address - Street 2:APT 3 A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5002
Mailing Address - Country:US
Mailing Address - Phone:860-593-3717
Mailing Address - Fax:
Practice Address - Street 1:118 E 19TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2127
Practice Address - Country:US
Practice Address - Phone:212-979-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058309122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist