MEDICARE: CATHERINE CHIAFAIR DMD

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
1	122300000X	Dentist	DN23385	FL

General Provider Information

NPI Number	:	1801388376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE CHIAFAIR DMD

Provider Business Mailing Address
First Line	:	9822 TAPESTRY PARK CIR UNIT 4
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-9258
Country	:	US
Telephone Number	:	904-906-6658
Fax Number	:

Provider Business Practice Location Address
First Line	:	9822 TAPESTRY PARK CIR UNIT 4
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-9258
Country	:	US
Telephone Number	:	904-906-6658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2018
Last Update Date	:	03/17/2026

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