Provider Demographics
NPI:1093012353
Name:CHAI, YOUNG AH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:YOUNG AH
Middle Name:
Last Name:CHAI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21500 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5018
Mailing Address - Country:US
Mailing Address - Phone:248-552-0166
Mailing Address - Fax:248-552-8478
Practice Address - Street 1:21500 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5018
Practice Address - Country:US
Practice Address - Phone:248-552-0166
Practice Address - Fax:248-552-8478
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist