Provider Demographics
NPI:1174157945
Name:CHICCONE, ERIC (MD, DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:CHICCONE
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7677 CENTER AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-9102
Mailing Address - Country:US
Mailing Address - Phone:714-766-6560
Mailing Address - Fax:
Practice Address - Street 1:7677 CENTER AVE STE 206
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-9102
Practice Address - Country:US
Practice Address - Phone:714-766-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2025-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1109541223S0112X
NJ22DI030232001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery