Provider Demographics
NPI:1205021995
Name:CHU, KARRIE TYLER (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARRIE
Middle Name:TYLER
Last Name:CHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8523 DAY ST
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1844
Mailing Address - Country:US
Mailing Address - Phone:818-271-7041
Mailing Address - Fax:
Practice Address - Street 1:277 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2717
Practice Address - Country:US
Practice Address - Phone:626-793-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice