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NPI Code Detail

MEDICARE: DR. TERI DIANNE CHAFIN D.M.D., M.P.H.

MEDICARE: DR. TERI DIANNE CHAFIN D.M.D., M.P.H.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryLNO 4771AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151519839CHAOTHERALBC/BS OF ALABAMA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
451519941CHAOTHERALBC/BS OF ALABAMA
551513226CHAOTHERALBC/BS OF ALABAMA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
851519943CHAOTHERALBC/BS OF ALABAMA

General Provider Information

NPI Number : 1114925625
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERI DIANNE CHAFIN D.M.D., M.P.H.
Provider Business Mailing Address
First Line : 1400 6TH AVE S
Second Line : DENTAL HEALTH SERVICES
City : BIRMINGHAM
State : AL
Zip : 35233-1502
Country : US
Telephone Number : 205-930-1422
Fax Number : 205-930-1448
Provider Business Practice Location Address
First Line : 1400 6TH AVE S
Second Line : DENTAL HEALTH SERVICES
City : BIRMINGHAM
State : AL
Zip : 35233-1502
Country : US
Telephone Number : 205-930-1422
Fax Number : 205-930-1448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 08/16/2007

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