Individual provider · Type 1 NPI

Jose Antonio Chacon

Orthodontics and Dentofacial Orthopedics Dentistry · Mayfield Heights, OH

NPI number 1649342064 Active

Practice location

5875 Landerbrook Dr Ste 250
Mayfield Heights, OH 44124-6502

Call (800) 487-4867 Map

Fax (216) 593-7533

Mailing address

125 E 13th St, # 1405
Chicago, IL 60605-2655

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	019-026092 (IL)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1649342064

Jose Antonio Chacon's National Provider Identifier is 1649342064, issued on Nov 14, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Mayfield Heights, OH. The record was last updated on Jul 8, 2007.