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General NPI Number Information
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NPI Number | 1295364966
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Entity Type | Individual
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Provider Name | MICHAEL GREGORY CHERNYAK DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2020
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2301 E ALLEGHENY AVE STE 206
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4427
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Country | US
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Telephone | 267-367-5009
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Fax |
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Provider Business Mailing Address
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Address Line | 1099 GERMANTOWN AVE APT G0619
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City | PHILADELPHIA
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State | PA
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Zip | 19123-0002
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Country | US
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Telephone | 917-500-4894
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS045430
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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