Provider Demographics
NPI:1104902535
Name:CHIU, HERBERT CK (DDS)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:CK
Last Name:CHIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 DECOTO RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-4940
Mailing Address - Country:US
Mailing Address - Phone:510-471-3777
Mailing Address - Fax:
Practice Address - Street 1:2701 DECOTO RD
Practice Address - Street 2:SUITE 4
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-4940
Practice Address - Country:US
Practice Address - Phone:510-471-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA337371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice