Provider Demographics
NPI:1962962480
Name:CHAUHAN, VIKRAM (DMD)
Entity type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:
Last Name:CHAUHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PLEASANT ST NW STE H
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4448
Mailing Address - Country:US
Mailing Address - Phone:703-281-2111
Mailing Address - Fax:703-281-0973
Practice Address - Street 1:1616 13TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3840
Practice Address - Country:US
Practice Address - Phone:304-691-1247
Practice Address - Fax:304-691-1248
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-21
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist