Provider Demographics
NPI:1033115894
Name:CHEN, KIM CHIN-PEI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:CHIN-PEI
Last Name:CHEN
Suffix:
Gender:F
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:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-0580
Mailing Address - Country:US
Mailing Address - Phone:559-386-4500
Mailing Address - Fax:
Practice Address - Street 1:20326 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CA
Practice Address - Zip Code:93266
Practice Address - Country:US
Practice Address - Phone:559-947-3505
Practice Address - Fax:559-947-3503
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist