Healthcare Provider Details

I. General information

NPI: 1518582881
Provider Name (Legal Business Name): DAVID CHUBB BDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 WESTERN AVE
SOUTH PORTLAND ME
04106-2410
US

IV. Provider business mailing address

7500 CAMBRIDGE ST STE 6150
HOUSTON TX
77054-2032
US

V. Phone/Fax

Practice location:
  • Phone: 207-774-5527
  • Fax:
Mailing address:
  • Phone: 713-486-4052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDEN5276
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: