Provider Demographics
NPI:1336428994
Name:CHAU, CHRISTOPHER MINH (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MINH
Last Name:CHAU
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 1:3132 WATERMARKE PL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-5614
Mailing Address - Country:US
Mailing Address - Phone:310-574-2909
Mailing Address - Fax:
Practice Address - Street 1:3132 WATERMARKE PL
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-5614
Practice Address - Country:US
Practice Address - Phone:310-574-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA621861223X0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program