Provider Demographics
NPI:1427110394
Name:CHIAMBAS, ALEXANDER K (DDS)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:K
Last Name:CHIAMBAS
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 1:601 W CENTRAL ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2379
Mailing Address - Country:US
Mailing Address - Phone:847-255-0777
Mailing Address - Fax:847-255-0777
Practice Address - Street 1:601 W CENTRAL ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2379
Practice Address - Country:US
Practice Address - Phone:847-255-0777
Practice Address - Fax:847-255-0777
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0218791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice