Provider Demographics
NPI:1770302390
Name:KUDZAI CHIKWAWA DDS LLC ASPIRE DENTISTRY
Entity type:Organization
Organization Name:KUDZAI CHIKWAWA DDS LLC ASPIRE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:KUDZAI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIKWAVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-622-4869
Mailing Address - Street 1:4727 BRAINERD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3847
Mailing Address - Country:US
Mailing Address - Phone:423-622-4869
Mailing Address - Fax:423-622-4875
Practice Address - Street 1:4727 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3847
Practice Address - Country:US
Practice Address - Phone:423-622-4869
Practice Address - Fax:423-622-4875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty