Provider Demographics
NPI:1811261423
Name:CHAGNIOT, PHILIPPE HENRI (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIPPE
Middle Name:HENRI
Last Name:CHAGNIOT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 BUCKINGHAM WAY
Mailing Address - Street 2:SUITE 417
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1909
Mailing Address - Country:US
Mailing Address - Phone:415-564-5477
Mailing Address - Fax:415-564-5477
Practice Address - Street 1:595 BUCKINGHAM WAY
Practice Address - Street 2:SUITE 417
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1909
Practice Address - Country:US
Practice Address - Phone:415-564-5477
Practice Address - Fax:415-564-5477
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA034073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA034073OtherCA DENTAL LICENSE NUMBER