Provider Demographics
NPI:1801870472
Name:CHIMA, MANDEEP K (DDS)
Entity type:Individual
Prefix:
First Name:MANDEEP
Middle Name:K
Last Name:CHIMA
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 1:1915 SPRINGSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4652
Mailing Address - Country:US
Mailing Address - Phone:530-218-7856
Mailing Address - Fax:330-884-6120
Practice Address - Street 1:726 WICK AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2827
Practice Address - Country:US
Practice Address - Phone:330-747-9551
Practice Address - Fax:330-884-6120
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30023842122300000X
CA465731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice