Healthcare Provider Details

I. General information

NPI: 1629707245
Provider Name (Legal Business Name): DR. CHRIS MICHAEL NAHAT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 NE JENSEN BEACH BLVD
JENSEN BEACH FL
34957-7295
US

IV. Provider business mailing address

1852 NE JENSEN BEACH BLVD
JENSEN BEACH FL
34957-7295
US

V. Phone/Fax

Practice location:
  • Phone: 772-617-4323
  • Fax:
Mailing address:
  • Phone: 772-617-4323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number26984
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: