Healthcare Provider Details

I. General information

NPI: 1730559634
Provider Name (Legal Business Name): HARDEEP CHEHAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CALIFORNIA PLZ
OMAHA NE
68178-0133
US

IV. Provider business mailing address

5050 GROVER ST # 5
OMAHA NE
68106-3891
US

V. Phone/Fax

Practice location:
  • Phone: 401-280-5645
  • Fax: 402-280-5094
Mailing address:
  • Phone: 703-969-9715
  • Fax: 402-280-5094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number119
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: