Provider Demographics
NPI:1699977991
Name:CHAVEZ, BELEN T (DMD)
Entity type:Individual
Prefix:DR
First Name:BELEN
Middle Name:T
Last Name:CHAVEZ
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 1:7409 TULARE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95139-1266
Mailing Address - Country:US
Mailing Address - Phone:408-829-8147
Mailing Address - Fax:
Practice Address - Street 1:61 SERRA WAY
Practice Address - Street 2:#212
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-8519
Practice Address - Country:US
Practice Address - Phone:408-829-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA548151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice