Provider Demographics
NPI:1730616863
Name:CHIMENTI, SYLVANA (DMD)
Entity type:Individual
Prefix:
First Name:SYLVANA
Middle Name:
Last Name:CHIMENTI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 MATTHEWS MINT HILL RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9492
Mailing Address - Country:US
Mailing Address - Phone:917-279-8073
Mailing Address - Fax:
Practice Address - Street 1:6820 MATTHEWS MINT HILL RD STE 204
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-9492
Practice Address - Country:US
Practice Address - Phone:917-279-8073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11244122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program