Provider Demographics
NPI:1427313477
Name:CHAVDA, ANISH NARENDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANISH
Middle Name:NARENDRA
Last Name:CHAVDA
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 1:25653 HIGHWAY 59 N STE 207
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1797
Mailing Address - Country:US
Mailing Address - Phone:832-463-4411
Mailing Address - Fax:
Practice Address - Street 1:25653 HIGHWAY 59 N STE 207
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1797
Practice Address - Country:US
Practice Address - Phone:832-463-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX318771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program