1366536930 NPI number — DR. CHRISTINA RHIANNON CHANDA MUELLER DDS

Table of content: DR. CHRISTINA RHIANNON CHANDA MUELLER DDS (NPI 1366536930)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366536930 NPI number — DR. CHRISTINA RHIANNON CHANDA MUELLER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANDA MUELLER
Provider First Name:
CHRISTINA
Provider Middle Name:
RHIANNON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366536930
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 SOMERSET DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY RIVER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44116-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-246-3375
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21851 CENTER RIDGE RD
Provider Second Line Business Practice Location Address:
#311
Provider Business Practice Location Address City Name:
ROCKY RIVER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44116-3976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-333-9532
Provider Business Practice Location Address Fax Number:
440-333-9533
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  30022161 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com