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General NPI Number Information
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NPI Number | 1598505380
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Entity Type | Organization
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Legal Business Name | SUSHILA CHAHAL DDS, PLLC
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1462 FLATBUSH AVE UNIT C-1
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City | BROOKLYN
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State | NY
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Zip | 11210-2382
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Country | US
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Telephone | 718-715-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 1462 FLATBUSH AVE UNIT C-1
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City | BROOKLYN
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State | NY
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Zip | 11210-2382
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | SUSHILA CHAHAL
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Credential |
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Telephone | 718-715-0727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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