Provider Demographics
NPI:1275735763
Name:CHEN, SHIH-HAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHIH-HAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:10933 ROCHESTER AVE APT 420
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-7716
Mailing Address - Country:US
Mailing Address - Phone:503-888-1537
Mailing Address - Fax:
Practice Address - Street 1:11600 WILSHIRE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1783
Practice Address - Country:US
Practice Address - Phone:310-441-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice