Provider Demographics
NPI:1912051566
Name:HYMAN, CHAIM (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:
Last Name:HYMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4885
Mailing Address - Country:US
Mailing Address - Phone:813-662-4848
Mailing Address - Fax:813-315-6373
Practice Address - Street 1:1327 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4885
Practice Address - Country:US
Practice Address - Phone:813-662-4848
Practice Address - Fax:813-315-6373
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16366122300000X
FL169251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL203244302OtherEIN NUMBER