Provider Demographics
NPI:1215058003
Name:WANETA CHENAULT D.D.S., P.A.
Entity type:Organization
Organization Name:WANETA CHENAULT D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WANETA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENAULT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-966-6686
Mailing Address - Street 1:2280 HIGHLAND VILLAGE RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7146
Mailing Address - Country:US
Mailing Address - Phone:972-966-6686
Mailing Address - Fax:972-966-0298
Practice Address - Street 1:2280 HIGHLAND VILLAGE RD
Practice Address - Street 2:SUITE #100
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7146
Practice Address - Country:US
Practice Address - Phone:972-966-6686
Practice Address - Fax:972-966-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty