Provider Demographics
NPI:1285314682
Name:DANIEL CHEN DDS, INC
Entity type:Organization
Organization Name:DANIEL CHEN DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN DDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-962-4428
Mailing Address - Street 1:1710 W CAMERON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2720
Mailing Address - Country:US
Mailing Address - Phone:626-962-4428
Mailing Address - Fax:
Practice Address - Street 1:1710 W CAMERON AVE STE 100
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2720
Practice Address - Country:US
Practice Address - Phone:626-962-4428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty