Provider Demographics
NPI:1891733622
Name:CHIAPEL, JOHN NICHOLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NICHOLAS
Last Name:CHIAPEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:NICHOLAS
Other - Last Name:CHIAPEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:16921 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1209
Mailing Address - Country:US
Mailing Address - Phone:636-405-1400
Mailing Address - Fax:636-405-1412
Practice Address - Street 1:16921 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1209
Practice Address - Country:US
Practice Address - Phone:636-405-1400
Practice Address - Fax:636-405-1412
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE 156621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery