Provider Demographics
NPI:1700153533
Name:JOHN P CHIBBARO, DDS PA
Entity Type:Organization
Organization Name:JOHN P CHIBBARO, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHIBBARO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-664-2324
Mailing Address - Street 1:333 OLD HOOK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3200
Mailing Address - Country:US
Mailing Address - Phone:201-664-2324
Mailing Address - Fax:201-664-2358
Practice Address - Street 1:333 OLD HOOK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3200
Practice Address - Country:US
Practice Address - Phone:201-664-2324
Practice Address - Fax:201-664-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ08416261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical