Provider Demographics
NPI:1124359716
Name:CHIU, FANG-TZU (DDS)
Entity Type:Individual
Prefix:
First Name:FANG-TZU
Middle Name:
Last Name:CHIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:FANG-TZU
Other - Last Name:CHIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:55 E LIVE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5234
Mailing Address - Country:US
Mailing Address - Phone:626-447-6089
Mailing Address - Fax:626-446-6822
Practice Address - Street 1:55 E LIVE OAK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5234
Practice Address - Country:US
Practice Address - Phone:626-447-6089
Practice Address - Fax:626-446-6822
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA589011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice