Provider Demographics
NPI:1952477747
Name:CHAUVIN, NANCY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:E
Last Name:CHAUVIN
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 1:816 LOWER DALLAS HWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:NC
Mailing Address - Zip Code:28034-9368
Mailing Address - Country:US
Mailing Address - Phone:704-922-4147
Mailing Address - Fax:704-922-9252
Practice Address - Street 1:816 LOWER DALLAS HWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:NC
Practice Address - Zip Code:28034-9368
Practice Address - Country:US
Practice Address - Phone:704-922-4147
Practice Address - Fax:704-922-9252
Is Sole Proprietor?:No
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC51331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC91536OtherBLUE CROSS ID
NC8991535Medicaid