Healthcare Provider Details

I. General information

NPI: 1790671469
Provider Name (Legal Business Name): BILAL ASHRAF CHAUDHARY DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9870 HIBERT ST STE D9
SAN DIEGO CA
92131-1091
US

IV. Provider business mailing address

2020 EL CAJON BLVD APT 600
SAN DIEGO CA
92104-3882
US

V. Phone/Fax

Practice location:
  • Phone: 858-433-7377
  • Fax:
Mailing address:
  • Phone: 646-407-5185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDDS111363
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: