Provider Demographics
NPI:1124148077
Name:TCHAGA, VERGINIA K (DDS)
Entity type:Individual
Prefix:DR
First Name:VERGINIA
Middle Name:K
Last Name:TCHAGA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 EL CAMINO REAL STE 250
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4289
Mailing Address - Country:US
Mailing Address - Phone:408-247-3740
Mailing Address - Fax:408-247-7873
Practice Address - Street 1:980 EL CAMINO REAL STE 250
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4289
Practice Address - Country:US
Practice Address - Phone:408-247-3740
Practice Address - Fax:408-247-7873
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist