Provider Demographics
NPI:1063553972
Name:CHIANESE, CHESTER CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:CHARLES
Last Name:CHIANESE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7566
Mailing Address - Country:US
Mailing Address - Phone:732-349-4040
Mailing Address - Fax:732-349-7144
Practice Address - Street 1:224 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7566
Practice Address - Country:US
Practice Address - Phone:732-349-4040
Practice Address - Fax:732-349-7144
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI012736001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice