Provider Demographics
NPI:1073749206
Name:CHEN-MIZUUCHI, EILEEN LIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:LIN
Last Name:CHEN-MIZUUCHI
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 1:930 DUNLEER DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5373
Mailing Address - Country:US
Mailing Address - Phone:469-301-1255
Mailing Address - Fax:
Practice Address - Street 1:5000 COLLIN MCKINNEY PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:469-301-1255
Practice Address - Fax:469-301-1255
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX252511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice