Provider Demographics
NPI:1427135847
Name:CHU, BEANCA (DDS)
Entity type:Individual
Prefix:DR
First Name:BEANCA
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BEANCA
Other - Middle Name:
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:20932 BROOKHURST ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6638
Mailing Address - Country:US
Mailing Address - Phone:714-962-9302
Mailing Address - Fax:714-963-0523
Practice Address - Street 1:20932 BROOKHURST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-6638
Practice Address - Country:US
Practice Address - Phone:714-962-9302
Practice Address - Fax:714-963-0523
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry