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General NPI Number Information
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NPI Number | 1710863246
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Entity Type | Individual
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Provider Name | TANAY VIJAYKUMAR CHAUBAL BDS, MDS
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Gender | Male
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1201 N STONEWALL AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1214
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Country | US
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Telephone | 405-271-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N STONEWALL AVE APT B-10
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-2819
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Country | US
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Telephone | 973-437-6352
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | FE-114
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License Number State | OK
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