Provider Demographics
NPI:1356677728
Name:TCHAKAROVA, LUDMILA H (DDS)
Entity type:Individual
Prefix:
First Name:LUDMILA
Middle Name:H
Last Name:TCHAKAROVA
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 1:9084 LAMBSKIN LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2939
Mailing Address - Country:US
Mailing Address - Phone:410-381-8283
Mailing Address - Fax:413-254-5304
Practice Address - Street 1:6801 DOUGLAS LEGUM DR STE C
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6273
Practice Address - Country:US
Practice Address - Phone:410-381-8283
Practice Address - Fax:413-254-5304
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD027642100Medicaid