Provider Demographics
NPI:1093955130
Name:CHEN, ANDREW T (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:CHEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 COIT RD.
Mailing Address - Street 2:STE #110
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4905
Mailing Address - Country:US
Mailing Address - Phone:469-200-0544
Mailing Address - Fax:888-977-2940
Practice Address - Street 1:7333 COIT RD.
Practice Address - Street 2:STE #110
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4905
Practice Address - Country:US
Practice Address - Phone:469-200-0544
Practice Address - Fax:888-977-2940
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0024394122300000X
PADS037601122300000X
TX243941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202829229Medicaid
TX202829230Medicaid