Provider Demographics
NPI:1568582252
Name:CHEGINI, SIMA F (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SIMA
Middle Name:F
Last Name:CHEGINI
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 1:2640 W MARKET ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4202
Mailing Address - Country:US
Mailing Address - Phone:330-835-1000
Mailing Address - Fax:330-835-3320
Practice Address - Street 1:2640 W MARKET ST
Practice Address - Street 2:SUITE 302
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4202
Practice Address - Country:US
Practice Address - Phone:330-835-1000
Practice Address - Fax:330-835-3320
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice