Provider Demographics
NPI:1588819346
Name:CHAPMAN, JOSHUA ALLAN (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALLAN
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3925 E. HAGAN ST.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401
Mailing Address - Country:US
Mailing Address - Phone:812-822-2489
Mailing Address - Fax:812-822-2594
Practice Address - Street 1:3925 E. HAGAN ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401
Practice Address - Country:US
Practice Address - Phone:812-822-2489
Practice Address - Fax:812-822-2594
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010732A1223X0400X
TX241341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics