Provider Demographics
NPI:1992794218
Name:CHEWNING, LEE CAIN (DMD)
Entity type:Individual
Prefix:MR
First Name:LEE
Middle Name:CAIN
Last Name:CHEWNING
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 1:191 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-2217
Mailing Address - Country:US
Mailing Address - Phone:724-774-6500
Mailing Address - Fax:724-774-6962
Practice Address - Street 1:191 S PARK ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-2217
Practice Address - Country:US
Practice Address - Phone:724-774-6800
Practice Address - Fax:724-774-6962
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022859L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA133842OtherBC/BS
PA0010034730001Medicaid
PA2278OtherHEALTH AMERICA
PA133842OtherBC/BS
T29449Medicare UPIN