Provider Demographics
NPI:1053523563
Name:NEVIN TCHAOUCHEVA DMD PC
Entity type:Organization
Organization Name:NEVIN TCHAOUCHEVA DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEVIN
Authorized Official - Middle Name:O
Authorized Official - Last Name:TCHAOUCHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:248-449-4300
Mailing Address - Street 1:41714 W. TEN MILE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375
Mailing Address - Country:US
Mailing Address - Phone:248-449-4300
Mailing Address - Fax:
Practice Address - Street 1:41714 W. TEN MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375
Practice Address - Country:US
Practice Address - Phone:248-449-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty