Provider Demographics
NPI:1073667457
Name:CHEN, CHIH-HUI WANDA (DDS)
Entity Type:Individual
Prefix:
First Name:CHIH-HUI WANDA
Middle Name:
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 1:30 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3113
Mailing Address - Country:US
Mailing Address - Phone:516-581-1141
Mailing Address - Fax:
Practice Address - Street 1:13443 MAPLE AVE UNIT C1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4527
Practice Address - Country:US
Practice Address - Phone:516-581-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0530041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice