Provider Demographics
NPI:1295723203
Name:CHIHA, ANTOINE E (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:E
Last Name:CHIHA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ANTOINE
Other - Middle Name:E
Other - Last Name:CHIHA DDS.PC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8440 FORT HAMILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4806
Mailing Address - Country:US
Mailing Address - Phone:718-833-5789
Mailing Address - Fax:718-745-1818
Practice Address - Street 1:8440 FORT HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4806
Practice Address - Country:US
Practice Address - Phone:718-833-5789
Practice Address - Fax:718-745-1818
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO184751223P0700X
NY0440261223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5408806Medicaid