Provider Demographics
NPI:1790077949
Name:CHENET COSMETIC AND FAMILY DENTISTRY P C
Entity Type:Organization
Organization Name:CHENET COSMETIC AND FAMILY DENTISTRY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHENET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-367-0367
Mailing Address - Street 1:200 COMMERCE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3189
Mailing Address - Country:US
Mailing Address - Phone:412-367-0367
Mailing Address - Fax:
Practice Address - Street 1:200 COMMERCE DR STE 203
Practice Address - Street 2:
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-3189
Practice Address - Country:US
Practice Address - Phone:412-367-0367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031576L332BC3200X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6522320001OtherDENTAL SLEEP MEDICINE
PA6522320001OtherPTAN