Provider Demographics
NPI:1023379732
Name:CHIEN & LI DENTAL, INC
Entity Type:Organization
Organization Name:CHIEN & LI DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHEN-FONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-287-8333
Mailing Address - Street 1:616 N GARFIELD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1153
Mailing Address - Country:US
Mailing Address - Phone:626-287-8333
Mailing Address - Fax:
Practice Address - Street 1:616 N GARFIELD AVE STE 102
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1153
Practice Address - Country:US
Practice Address - Phone:626-287-8333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389761223G0001X
CA398331223G0001X
CA554141223G0001X
CA598801223G0001X
CA565891223G0001X
CA531751223P0300X
CA1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty