Healthcare Provider Details

I. General information

NPI: 1083358741
Provider Name (Legal Business Name): DAYL THERESE CHACHAPPAN BDS MPH MSDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2254 S EUCLID AVE STE B
ONTARIO CA
91762-6574
US

IV. Provider business mailing address

2254 S EUCLID AVE STE B
ONTARIO CA
91762-6574
US

V. Phone/Fax

Practice location:
  • Phone: 999-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number107378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: