Provider Demographics
NPI:1124151592
Name:CHIN, JUDITH RENEE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:RENEE
Last Name:CHIN
Suffix:
Gender:
Credentials:DDS, MS
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Mailing Address - Street 1:3300 S UNIVERSITY DR RM 4317
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2004
Mailing Address - Country:US
Mailing Address - Phone:954-262-7663
Mailing Address - Fax:954-262-1782
Practice Address - Street 1:819 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1239
Practice Address - Country:US
Practice Address - Phone:954-262-7663
Practice Address - Fax:954-262-1782
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN120097241223P0221X
CA472071223P0221X
FLDN240181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry