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

LicenseStateTypeSpecialty
DI21576NJMDEndodontist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in West Orange, NJ

All providers in West Orange, NJ · Endodontics in New Jersey

Sources for this page

Verify at the official NPI Registry.