Healthcare Provider Details

I. General information

NPI: 1518304658
Provider Name (Legal Business Name): ALEXIS CHAUHAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE
TOLEDO OH
43614-2595
US

IV. Provider business mailing address

3000 ARLINGTON AVENUE MAIL STOP 1132
TOLEDO OH
43614
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-3805
  • Fax: 419-383-2969
Mailing address:
  • Phone: 419-383-3805
  • Fax: 419-383-2969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD008654
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: