Provider Demographics
NPI:1295852275
Name:CHIANG, SHUN LIN IRENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHUN LIN
Middle Name:IRENE
Last Name:CHIANG
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 1:17834 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504
Mailing Address - Country:US
Mailing Address - Phone:310-200-2367
Mailing Address - Fax:310-371-5856
Practice Address - Street 1:2021 W CARSON ST
Practice Address - Street 2:SUITE D
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-787-9728
Practice Address - Fax:310-371-5856
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist