Provider Demographics
NPI:1386760338
Name:CHIKUNOV, IGOR (DDS)
Entity type:Individual
Prefix:DR
First Name:IGOR
Middle Name:
Last Name:CHIKUNOV
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 1:6155 98TH ST APT 11K
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1438
Mailing Address - Country:US
Mailing Address - Phone:718-760-2221
Mailing Address - Fax:
Practice Address - Street 1:54 WARREN ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1078
Practice Address - Country:US
Practice Address - Phone:212-561-5303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2009-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0519051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics