Provider Demographics
NPI:1972316115
Name:CHELYAN DENTAL, PLLC
Entity type:Organization
Organization Name:CHELYAN DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:AMOS
Authorized Official - Last Name:GHAREEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-610-9973
Mailing Address - Street 1:105 B ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-1806
Mailing Address - Country:US
Mailing Address - Phone:304-415-6474
Mailing Address - Fax:304-744-8245
Practice Address - Street 1:15081 MACCORKLE AVNENUE
Practice Address - Street 2:
Practice Address - City:CABIN CREEK
Practice Address - State:WV
Practice Address - Zip Code:25083
Practice Address - Country:US
Practice Address - Phone:681-221-7313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty