Provider Demographics
| NPI: | 1174781942 |
|---|---|
| Name: | CHLOE CHU, D.D.S., A.P.C. |
| Entity type: | Organization |
| Organization Name: | CHLOE CHU, D.D.S., A.P.C. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | C.E.O. |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | CHLOE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CHU |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | DDS |
| Authorized Official - Phone: | 408-894-8135 |
| Mailing Address - Street 1: | 3720 N 1ST ST |
| Mailing Address - Street 2: | SUITE C |
| Mailing Address - City: | SAN JOSE |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 95134-1716 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 408-894-8135 |
| Mailing Address - Fax: | 408-894-8149 |
| Practice Address - Street 1: | 3720 N 1ST ST |
| Practice Address - Street 2: | SUITE C |
| Practice Address - City: | SAN JOSE |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 95134-1716 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 408-894-8135 |
| Practice Address - Fax: | 408-894-8149 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-05-29 |
| Last Update Date: | 2008-05-29 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | 42288 | 1223G0001X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 1223G0001X | Dental Providers | Dentist | General Practice | Group - Multi-Specialty |