Provider Demographics
NPI:1528408754
Name:CHOPRA, TINNYSHA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TINNYSHA
Middle Name:A
Last Name:CHOPRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-2326
Mailing Address - Country:US
Mailing Address - Phone:860-388-4433
Mailing Address - Fax:
Practice Address - Street 1:263 MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2326
Practice Address - Country:US
Practice Address - Phone:860-388-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT112371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice