Physician Compare National (NPI:1093754467)

HEALTHCARE PROVIDER: ROSS ORAN CHAVKIN DDS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093754467
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4880907112
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151229000143
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAVKIN
	Individual professional last name
Provider First Name	ROSS
	Individual professional first name
Provider Middle Name	O
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UN OF NY, BUFFALO SCHOOL OF DENTAL MEDICINE
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	SLEEP MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	SLEEP MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	425 BROADHOLLOW RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	MELVILLE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117474701
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6317521033
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y