Provider Demographics
NPI:1750016747
Name:JUSTIN CHAHINE
Entity type:Organization
Organization Name:JUSTIN CHAHINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAHINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-252-1600
Mailing Address - Street 1:3200 N MACARTHUR BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4404
Mailing Address - Country:US
Mailing Address - Phone:197-225-2160
Mailing Address - Fax:
Practice Address - Street 1:3200 N MACARTHUR BLVD STE 212
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4404
Practice Address - Country:US
Practice Address - Phone:197-225-2160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty