Provider Demographics
NPI:1033751698
Name:TING FONG CHEN DDS
Entity Type:Organization
Organization Name:TING FONG CHEN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS SPEICALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-544-2345
Mailing Address - Street 1:PO BOX 3000
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-8001
Mailing Address - Country:US
Mailing Address - Phone:503-588-1411
Mailing Address - Fax:503-315-7227
Practice Address - Street 1:335 W BROADWAY STE A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1324
Practice Address - Country:US
Practice Address - Phone:818-502-1991
Practice Address - Fax:503-315-7227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty