Healthcare Provider Details

I. General information

NPI: 1992811863
Provider Name (Legal Business Name): NICOLE DECARIA CHENET DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 COMMERCE DR STE 203
MOON TWP PA
15108-3189
US

IV. Provider business mailing address

200 COMMERCE DR STE 203
MOON TWP PA
15108-3189
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-0367
  • Fax: 412-367-0366
Mailing address:
  • Phone: 412-367-0367
  • Fax: 412-367-0366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS031576L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: