Provider Demographics
NPI:1699805838
Name:CHAMBARLIS, JOHN NICKIFOROS (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NICKIFOROS
Last Name:CHAMBARLIS
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 1:2705 MILLERS WAY DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1958
Mailing Address - Country:US
Mailing Address - Phone:410-461-8427
Mailing Address - Fax:
Practice Address - Street 1:8895 CENTRE PARK DR
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1966
Practice Address - Country:US
Practice Address - Phone:410-997-3100
Practice Address - Fax:410-997-3105
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100191223G0001X
MD10,0191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice