Provider Demographics
NPI:1922437383
Name:WARREN, CHEYANNE ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHEYANNE
Middle Name:ELIZABETH
Last Name:WARREN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 TOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-9425
Mailing Address - Country:US
Mailing Address - Phone:802-454-8336
Mailing Address - Fax:802-454-8339
Practice Address - Street 1:157 TOWNE AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667-9425
Practice Address - Country:US
Practice Address - Phone:802-454-8336
Practice Address - Fax:802-454-8339
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0442000199122300000X
VT0160105680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist