Provider Demographics
NPI:1699506675
Name:CHEN, DONGZI (DMD)
Entity type:Individual
Prefix:
First Name:DONGZI
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4544 COLUMBUS ST APT 916
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7385
Mailing Address - Country:US
Mailing Address - Phone:267-665-9580
Mailing Address - Fax:
Practice Address - Street 1:3388 PRINCESS ANNE RD STE 4000
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-2627
Practice Address - Country:US
Practice Address - Phone:757-381-6056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014191461223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics