Provider Demographics
NPI:1982725388
Name:CHAVEZ, BRIANA (DDS)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 S BRISTOL ST STE 304
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7316
Mailing Address - Country:US
Mailing Address - Phone:714-439-9800
Mailing Address - Fax:714-439-9819
Practice Address - Street 1:3620 S BRISTOL ST STE 304
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7316
Practice Address - Country:US
Practice Address - Phone:714-439-9800
Practice Address - Fax:714-439-9819
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice