Provider Demographics
NPI:1750055778
Name:CHAVAN, AMIT PRABHAKAR (MDS, MS)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:PRABHAKAR
Last Name:CHAVAN
Suffix:
Gender:M
Credentials:MDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 MURRAY CIR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-6750
Mailing Address - Country:US
Mailing Address - Phone:248-843-3528
Mailing Address - Fax:
Practice Address - Street 1:9100 CENTRE POINTE DR STE 200
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4856
Practice Address - Country:US
Practice Address - Phone:513-342-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0266091223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics