Provider Demographics
NPI:1316253016
Name:CHIN, WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:CHIN
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 1:1253 7TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1617
Mailing Address - Country:US
Mailing Address - Phone:310-393-2198
Mailing Address - Fax:310-459-5745
Practice Address - Street 1:1253 7TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1617
Practice Address - Country:US
Practice Address - Phone:310-393-2198
Practice Address - Fax:310-459-5745
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice