Healthcare Provider Details

I. General information

NPI: 1689961575
Provider Name (Legal Business Name): DEAN CHENCHARIK D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 WORLDS FAIR DR STE 501
SOMERSET NJ
08873-1396
US

IV. Provider business mailing address

475 SEAVIEW AVE
STATEN ISLAND NY
10305-3436
US

V. Phone/Fax

Practice location:
  • Phone: 732-846-7100
  • Fax:
Mailing address:
  • Phone: 718-226-9877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02494800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: