Joseph D Chikvashvili, D.D.S.
Individual provider Active NPI Endodontics · West Orange, NJ
NPI 1700096047 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700096047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- DI21576 (NJ)
- Practice address
- 100 Northfield Ave
West Orange, NJ 07052-4702 - Phone
- (973) 731-4800
- Fax
- (973) 731-1153
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI21576 | NJ | MD | Endodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DI21576 | NJ | Yes |
Addresses
Primary practice location
100 Northfield Ave
West Orange, NJ 07052-4702
Mailing address
100 Northfield Ave
West Orange, NJ 07052-4702
Phone (973) 731-4800
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All providers in West Orange, NJ · Endodontics in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.