Provider Demographics
NPI:1629145693
Name:MCHANEY, TODD ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALEXANDER
Last Name:MCHANEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:YYY
Other - Middle Name:YYY
Other - Last Name:YYY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1435 E AVENIDA KINO
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-1032
Mailing Address - Country:US
Mailing Address - Phone:520-421-3407
Mailing Address - Fax:
Practice Address - Street 1:485 S DOBSON RD
Practice Address - Street 2:STE 204
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5602
Practice Address - Country:US
Practice Address - Phone:480-821-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD58621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice