Provider Demographics
NPI:1851170500
Name:ARMENTHA D PROSPER-CHICAS, DDS, PLLC
Entity Type:Organization
Organization Name:ARMENTHA D PROSPER-CHICAS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMENTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PROSPER-CHICAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:980-434-6172
Mailing Address - Street 1:11638 KEMPSFORD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-2512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9623 BAILEY ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031
Practice Address - Country:US
Practice Address - Phone:980-434-6172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty