Provider Demographics
NPI:1861647653
Name:CHIFFERT, CLAUDE
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:CHIFFERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 E 82ND ST
Mailing Address - Street 2:STE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1500
Mailing Address - Country:US
Mailing Address - Phone:317-577-5764
Mailing Address - Fax:317-577-5753
Practice Address - Street 1:6150 E 82ND ST
Practice Address - Street 2:STE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1500
Practice Address - Country:US
Practice Address - Phone:317-577-5764
Practice Address - Fax:317-577-5753
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009642A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice