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General NPI Number Information
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NPI Number | 1699805838
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Entity Type | Individual
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Provider Name | JOHN NICKIFOROS CHAMBARLIS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 8895 CENTRE PARK DR SUITE D
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City | COLUMBIA
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State | MD
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Zip | 21045-1966
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Country | US
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Telephone | 410-997-3100
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Fax | 410-997-3105
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Provider Business Mailing Address
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Address Line | 2705 MILLERS WAY DR
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-1958
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Country | US
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Telephone | 410-461-8427
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10019
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License Number State | MD
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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 | 10,019
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License Number State | MD
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