Provider Demographics
NPI:1164466132
Name:CHEN, FRANK F (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:F
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 S HAM LN
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3530
Mailing Address - Country:US
Mailing Address - Phone:209-333-9888
Mailing Address - Fax:209-333-8600
Practice Address - Street 1:541 S HAM LN
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3530
Practice Address - Country:US
Practice Address - Phone:209-333-9888
Practice Address - Fax:209-333-8600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43768122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9253601Medicaid