Healthcare Provider Details

I. General information

NPI: 1477542157
Provider Name (Legal Business Name): NEELIMA CHINIWALLA D.M.D., M.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SMITH DR SUITE 2
CRANBERRY TWP PA
16066-4133
US

IV. Provider business mailing address

160 LINGAY DR
GLENSHAW PA
15116-1039
US

V. Phone/Fax

Practice location:
  • Phone: 724-776-9033
  • Fax: 724-776-9027
Mailing address:
  • Phone: 724-487-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS020597L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: