Provider Demographics
NPI:1760684500
Name:NICHOLAS JAMES CHAUVIN DDS PC
Entity Type:Organization
Organization Name:NICHOLAS JAMES CHAUVIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CHAUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-371-2500
Mailing Address - Street 1:516 VISCHER-FERRY ROAD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065
Mailing Address - Country:US
Mailing Address - Phone:518-371-2500
Mailing Address - Fax:
Practice Address - Street 1:516 VISCHER FERRY RD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-1656
Practice Address - Country:US
Practice Address - Phone:518-371-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0515081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty