Provider Demographics
NPI:1114381720
Name:CHEN, MEI-JEN (DDS)
Entity type:Individual
Prefix:
First Name:MEI-JEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4688 KINGSWAY
Mailing Address - Street 2:APT 703
Mailing Address - City:BURNABY
Mailing Address - State:BC
Mailing Address - Zip Code:V5H0E9
Mailing Address - Country:CA
Mailing Address - Phone:414-502-6267
Mailing Address - Fax:
Practice Address - Street 1:8012 112TH STREET CT E
Practice Address - Street 2:#320
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7856
Practice Address - Country:US
Practice Address - Phone:253-848-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60581683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist