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NPI Code Detail

MEDICARE: CHAITANYA H RAVAL D.D.S.

MEDICARE: CHAITANYA H RAVAL D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist15487MD
21223G0001XGeneral Practice Dentistry33709TX

General Provider Information

NPI Number : 1619319662
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAITANYA H RAVAL D.D.S.
Provider Business Mailing Address
First Line : 1107 S MACARTHUR BLVD
Second Line :
City : IRVING
State : TX
Zip : 75060-3827
Country : US
Telephone Number : 630-815-9633
Fax Number :
Provider Business Practice Location Address
First Line : 1107 S MACARTHUR BLVD
Second Line :
City : IRVING
State : TX
Zip : 75060-3827
Country : US
Telephone Number : 630-815-9633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2013
Last Update Date : 01/11/2021

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