Provider Demographics
NPI:1053511857
Name:CHAN, AMANDA HWE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:HWE
Last Name:CHAN
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 1:20 E 46TH ST
Mailing Address - Street 2:SUITE #1000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2417
Mailing Address - Country:US
Mailing Address - Phone:212-813-0850
Mailing Address - Fax:212-813-1181
Practice Address - Street 1:20 E 46TH ST
Practice Address - Street 2:SUITE #1000
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2417
Practice Address - Country:US
Practice Address - Phone:212-813-0850
Practice Address - Fax:212-813-1181
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050694122300000X
CA51238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist