Provider Demographics
NPI:1508856501
Name:CHAINANI ASHOK NANIKRAM BDS,PC
Entity Type:Organization
Organization Name:CHAINANI ASHOK NANIKRAM BDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHAINANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-720-0066
Mailing Address - Street 1:45 KEUNE CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1430
Mailing Address - Country:US
Mailing Address - Phone:718-720-0066
Mailing Address - Fax:718-720-0002
Practice Address - Street 1:253 BROAD ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2042
Practice Address - Country:US
Practice Address - Phone:718-720-0066
Practice Address - Fax:718-720-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036727261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00842824Medicaid