Provider Demographics
NPI:1598998148
Name:CHITKARA, SURINA (DDS)
Entity Type:Individual
Prefix:
First Name:SURINA
Middle Name:
Last Name:CHITKARA
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 1:190 N MOORE RD
Mailing Address - Street 2:UNIT 6206
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5233
Mailing Address - Country:US
Mailing Address - Phone:469-387-3498
Mailing Address - Fax:708-850-1608
Practice Address - Street 1:3010 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2723
Practice Address - Country:US
Practice Address - Phone:972-444-8888
Practice Address - Fax:972-243-6059
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice