Provider Demographics
NPI:1528282712
Name:CHIMINELLO, FRENK J (DMD)
Entity type:Individual
Prefix:DR
First Name:FRENK
Middle Name:J
Last Name:CHIMINELLO
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 1:45 NAHANT ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-3302
Mailing Address - Country:US
Mailing Address - Phone:781-593-7200
Mailing Address - Fax:781-592-6554
Practice Address - Street 1:45 NAHANT ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-3302
Practice Address - Country:US
Practice Address - Phone:781-593-7200
Practice Address - Fax:781-592-6554
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX03640OtherBLUECROSSBLUESHIELD