Provider Demographics
NPI:1518925270
Name:MAHAPAURYA, CHANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:
Last Name:MAHAPAURYA
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 1:106 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-2917
Mailing Address - Country:US
Mailing Address - Phone:912-527-1100
Mailing Address - Fax:502-996-8282
Practice Address - Street 1:106 E BROAD ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-2917
Practice Address - Country:US
Practice Address - Phone:912-527-1085
Practice Address - Fax:912-527-1083
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93461223G0001X
DCDEN58581223G0001X
WV33531223G0001X
MD122691223G0001X
GADN0137941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice