Provider Demographics
NPI:1063683423
Name:STEVEN L. CHIU, D.D.S., INC.
Entity Type:Organization
Organization Name:STEVEN L. CHIU, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LI-CHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-965-5618
Mailing Address - Street 1:13768 ROSWELL AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1407
Mailing Address - Country:US
Mailing Address - Phone:909-590-8255
Mailing Address - Fax:626-965-6786
Practice Address - Street 1:1183 E FOOTHILL BLVD STE 150
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4049
Practice Address - Country:US
Practice Address - Phone:909-931-2885
Practice Address - Fax:626-965-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA386611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1619187440OtherNPI TYPE 1
CA1679763080OtherNPI TYPE 2
CAB38661-01OtherDENTI-CAL