Provider Demographics
NPI:1629168877
Name:CHIMON, ERIC S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:CHIMON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3460
Mailing Address - Country:US
Mailing Address - Phone:516-692-9578
Mailing Address - Fax:
Practice Address - Street 1:640 FULTON ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3460
Practice Address - Country:US
Practice Address - Phone:516-694-2106
Practice Address - Fax:516-694-2131
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist