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NPI Code Detail

MEDICARE: JUAN CHAVEZ DMD

MEDICARE: JUAN CHAVEZ 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
1122300000XDentist064886NY
21223G0001XGeneral Practice Dentistry064886NY

General Provider Information

NPI Number : 1831958214
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN CHAVEZ DMD
Provider Business Mailing Address
First Line : 111 LAWRENCE ST APT 19A
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-3876
Country : US
Telephone Number : 954-756-1440
Fax Number :
Provider Business Practice Location Address
First Line : 505 CLAREMONT PKWY
Second Line :
City : BRONX
State : NY
Zip : 10457-8304
Country : US
Telephone Number : 718-299-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2024
Last Update Date : 03/16/2026

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