Provider Demographics
NPI:1558422592
Name:CHESIRE, TARYN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TARYN
Middle Name:MARIE
Last Name:CHESIRE
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 1:18715 V ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-4166
Mailing Address - Country:US
Mailing Address - Phone:402-871-9443
Mailing Address - Fax:
Practice Address - Street 1:989375 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-9375
Practice Address - Country:US
Practice Address - Phone:402-559-6100
Practice Address - Fax:402-559-9607
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE65501223D0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223D0001XDental ProvidersDentistDental Public Health
Not Answered1223G0001XDental ProvidersDentistGeneral Practice