Provider Demographics
NPI:1063799062
Name:CHRIS CHEN. DMD, MPH, PLLC
Entity type:Organization
Organization Name:CHRIS CHEN. DMD, MPH, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MPH
Authorized Official - Phone:425-883-3399
Mailing Address - Street 1:15446 BEL RED RD STE 300
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5507
Mailing Address - Country:US
Mailing Address - Phone:425-883-3399
Mailing Address - Fax:425-883-3391
Practice Address - Street 1:15446 BEL RED RD STE 300
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5507
Practice Address - Country:US
Practice Address - Phone:425-883-3399
Practice Address - Fax:425-883-3391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60073326261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental