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NPI Code Detail

MEDICARE: DR. WALDEMAR CHMIELEWSKI DDS

MEDICARE: DR. WALDEMAR CHMIELEWSKI DDS
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
11223G0001XGeneral Practice Dentistry39387CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
139387OTHERCASTATE LICENCE

General Provider Information

NPI Number : 1720132525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WALDEMAR CHMIELEWSKI DDS
Provider Business Mailing Address
First Line : 11510 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6522
Country : US
Telephone Number : 323-756-8334
Fax Number : 323-756-8338
Provider Business Practice Location Address
First Line : 11510 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6522
Country : US
Telephone Number : 323-756-8334
Fax Number : 323-756-8338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 07/08/2007

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